Atypical APs v. Typical APs

[Libby]

My dx are MDD and GAD. I started taking Seroquel about a month ago primarily for insomnia. Much to my surprise and relief, my incessant suicidal thoughts have stopped cold. Also, my mood is improving. And, my anxiety is at a lifetime LOW. I'm not even taking Klonopin.

So, all of that is great.

But, I have put on 12 lbs and it seems to be climbing. I'm already quite overweight and thereby at risk for diabetes. Also, Seroquel is very expensive, and I do not have insurance.

So, I'm wondering if I can go to a old AP like Navane and have the same results without hte weight gain/diabetes problem.

Do the old APs affect the same neurotransmitters as Seroquel?

What's the difference?

[Velvet Elvis]

My dx are MDD and GAD. I started taking Seroquel about a month ago primarily for insomnia. Much to my surprise and relief, my incessant suicidal thoughts have stopped cold. Also, my mood is improving. And, my anxiety is at a lifetime LOW. I'm not even taking Klonopin.

So, all of that is great.

But, I have put on 12 lbs and it seems to be climbing. I'm already quite overweight and thereby at risk for diabetes. Also, Seroquel is very expensive, and I do not have insurance.

So, I'm wondering if I can go to a old AP like Navane and have the same results without the weight gain/diabetes problem.

Do the old APs affect the same neurotransmitters as Seroquel?

What's the difference?

As far classifications goes, the difference is one of molecular structure. The typicals fall into two classes: the phenothiazines (chlorpromazine and analogs) and the butyrophenones (haloperidol and analogs).

New APs are termed "atypical" simply because their molecular structure was different from that of the old drugs.

OK. Side effects. There's a reason why these things aren't used anymore. At higher doses there is a rist of Tardive Dyskinesia (TD). This can manifest itself as a variety of movement disorders such as twitching of the eyelids, lips, or limbs. It can persist after taking the medication, sometimes for life.

The risk is much lower at lower doses. I'd imagine that the cognitive effects would average out more on the zyprexa end of the spectrum, though YMMV. I'd guess that Melleril would be the least likely to take a chainsaw to your brain.

I'm planning on calling my pdoc this week to ask for a mircodose of thorzine for sleep since seroquel is so damn expensive.

I'm with on the seroquel. It's been a holy grail medication. A holy grail medication that made me gain 100 pounds. It did wonder for my anxiety as well.

[AirMarshall]

My mom has been on Stelazine for depression for 40 years. She likes it and won't give it up, even though a couple Pdocs have tried to convince her to.

a.m.

[Libby]

So, I'm wondering if I can go to a old AP like Navane and have the same results without the weight gain/diabetes problem.

Do the old APs affect the same neurotransmitters as Seroquel?

[Velvet Elvis]

You're likely to most of the same side effects and then some. You could save a lot of money though.

Here is the wikipedia entry:

http://en.wikipedia.org/wiki/Typical_antipsychotic

[Loon-A-TiK]

Yes, as VE said, the difference is in the molecular structure. I asked my uncle who has his PhD in Chemistry and his BS in Pharmacy and he agreed.

[Libby]

Thanks, but I don't really care about molecular structure. I was hoping for a comparison of respective symptoms they treat and their respective side effects.

[ehygon]

Thanks, but I don't really care about molecular structure. I was hoping for a comparison of respective symptoms they treat and their respective side effects.

I think what they're saying, is that the only difference between typical APs and atypical, is the structure. The side effects come from the mechanism and brain areas the drug acts in, not the shape. Because they are all doing essentially the same thing, you'll get essentially the same effects.

I could be wrong, but I believe atypicals have become preferred, because the rates of EPS and TD are lower. I've noticed many times on CB where people have pointed out, typicals are as effective as atypicals, aside from clozaril.

elvis's link to wikipedia was also in resposnse to your side effects questions. Particularly, the difference between low and high potentcy APs, and the frequency of things like weight gain and EPS. In general, the possible side effects are the same between AAPS and TAPS

[Libby]

I've noticed many times on CB where people have pointed out, typicals are as effective as atypicals, aside from clozaril.

What's the deal with Clozaril?

[Velvet Elvis]

It's more effective than most but requires weekly blood tests

If you have no health insurence, that cost alone pretty much rules it out.

[HazelBLK]

My experience with the typicals was that Mellaril caused severe weight gain whereas Stelazine didn't. I really liked Stelazine a lot but it caused shaking hands sometimes. This was way back when and with the Stelazine I had to use Cogentin for side effects - it's good stuff but hard to get anymore.