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Which APs are best for psychotic symptoms AND mood?


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And are hopefully weight-neutral.

Invega is not cutting it as a mood stabilizer, though it does my psychotic features just fine. Am now on too low a dose of Seroquel for mood stabilization (at 200mg right now - it works for me at 800mg, but I'm not going back onto it). Geodon has too many negative side effects for me.

Since I'm on Invega, I wasn't going to bother with Risperdal. I've heard Abilify isn't very good with mood.

I also am overweight and trying to lose weight - I HAVE to lose it.

My psychopharm prefers that I be on one med, ideally (currently on 3). I see him next Monday.

I would prefer not to switch meds, though if I don't, I want a mood stabilizer other than Lyrica. So no matter what, I think I am looking at some form of med switch. Sigh. But without a mood stabilizer I have been depressed on the Invega.

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Generally, the AAPs are the antipsychotics with mood stabilizing powers. You've already named all except for the latest releases. Given the meds you've ruled out, your best bet may be to add Lithium or a stabilizing anticonvulsant (Depakote, Tegretol, Trileptal, etc). Then you might be able to take lower doses of it and an AAP or loose the AAP altogether, maybe. The rationale is that if you are stable, you should not have psychotic symptoms since those are part of an episode.

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Don't cut out zyprexa before you try it first. You really don't know if you are a weight-gainer or not on it until you try. I've been on it since February, and I've gained a couple of pounds during months 4-5, and then have been slowly losing them since. All told, I've gained about 8 pounds, but like I said, I'm slowly and steadily losing it. To be honest with you, I probably wouldn't have gained the weight if I didn't have an insatiable urge for bacon sandwiches every day, lol.

And honestly, 8 pounds for 9 months of sanity is a pretty even trade in my book.

Also, I just started taking the zyprexa zydis, and it really does help the appetite issues.

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Thanks guys.

I really am terrified of the weight gain w/Zyprexa - I need to lose weight, derailing that process would be very bad for me.

Stacia, I have been on lithium (and lamotrigine) before - by itself, lithium did not work as a mood stabilizer, though it might in conjunction w/another med. Worth asking about, especially if they put me on synthroid right off the bat this time.

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I've taken Zyprexa for mood stabilization and it works pretty well. Not everyone gains weight on that medication. I was on 15mg @ bedtime. I did have some restlessness but that was it in terms of the Zyprexa side effects for me. Don't knock it till you try it. It may work very well for you. I wish you the best.

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Thanks. I will talk to my doctor. The problem is I'm an endurance athlete and the extra weight I am already carrying is already a big problem, so more is a disaster.

I'm having some mild breakthrough paranoia, so we'll see what he says.

Depression normally is not an issue for me - literally just since I started taking the Invega, so maybe now I'm thinking it makes me depressed - don't know if that's a side effect or not. Huh.

I am wondering about Invega (up to 9mg from 6mg for the breakthrough stuff????) + lithium, and hoping it works as a mood stabilizer this time.

I'm sort of torn. I don't want to change meds, AGAIN. This year has been a lot of med changes, sheesh.

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Talk to your doc about the zydis formulation of zyprexa. It really is better for a lot of folks in the weight gain department.

It's hard to say FOR SURE how any particular AAp is going to impact your mood.... The individual responses really do vary quite a bit. What is perfect for one person may be a complete train wreck for others. Abilify is pretty split down the middle with some folks finding it helpful, and others not. So, it may be the time (as much as you hate it, and I don't blame you) for some judicious experimenting.

Keep a mood and side effects journal, so that you know what's what, while you are doing so.

Good luck

Anna

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Thanks.

I wonder if the Zydis is available in Canada - well, I'll see what the doc says about switching. But I am pretty sure that the Invega is causing the depression, I've tended to the other pole for a few years until exactly the time I started taking the Invega. Too coincidental.

Journalling! Yikes! ;)

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jarn,

i have had tremendous good luck with zydis and the small amount of weight gain has been worth the self confidence I feel in myself now in terms of my stability and resilience. The weight gain doesn't happen overnight, the trick is you have to follow a very restrictive diet, for example, a diet which would cause most normal people to lose weight would be weight-neutral with zyprexa. so you have to FILL your kitchen with salad, fruits, nonfat yogurts, and such for when you get the munchies. If you're an athlete, then burning more calories than youre taking in should not be too much problem. At any rate, I have found zyprexa to be worth the hassle.

--lluv

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Thanks lluv!

I saw my psychopharmacologist today and I'm staying on Invega and Lyrica, going off Seroquel, and going on Lamotrigine for mood stabilization/to counteract the depressive side effect of Invega.

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Thanks lluv!

I saw my psychopharmacologist today and I'm staying on Invega and Lyrica, going off Seroquel, and going on Lamotrigine for mood stabilization/to counteract the depressive side effect of Invega.

Best of luck with the change. Hope it all works out for you...

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Thanks.

We had a discussion about which route to take, but this seemed best. We know the Invega works well for my ideas of reference etc, and that's important.

....hopefully this will be weight-neutral! So I can keep losing!

I'm already feeling a bit of nausea. Possibly from stopping the Seroquel though.

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