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I am BP and my current AP is not working alone by itself so far. I talked to my pdoc about Zyprexa but she sees a lot of weight gain with Zyprexa patients and doesn't want me to risk it since I'm big enough, lol. Anyways, I was looking at Clozaril and thought it might be good, I like the fact that it has a benzo feature as well since my mania is pretty bad (1mg of ativan quashes it for like 2 hours and that's it). Any advice?

Current cocktail:

Ambien 10mg-sleep

Abilify 35mg- antipsych

lamictal 100mg- titrating up

Ativan-4mg

Edited by Erinface
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Weight gain is a tough issue with Clozaril as well.  You might want to talk to your doc about Zydis, the sol-tab version of Zyprexa.  For some reason, this version of the medication is less associated with massive weight gain. 

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the first time i took zyprexa i gained a lot of weight. This second time I took the zydis versión combined with metformin and gained half the weight I gained lást time. The weight gained is caused by insulin resistance which is treated with metformin. My doctor loves zyprexa because he says it gives him the best results. Tell your doctor to give you different options

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I had a bad experience with clozaril.  It totally messed up my sleep and (over)eating, and my WBC went to almost 0, and when I stopped taking it the sleep and eating didn't improve/go away.  The WBC did get back to normal eventually though.  But that is me; a lot of people have positive experiences with it too.

 

If you do decide to take it though, be prepared for weekly bloodwork, only getting a week of meds at a time, and possibly affect your WBC.

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Honestly, I don't think that anyone should go on Clozaril unless it's absolutely necessary. It's meant to be used as a last resort. I too had a bad experience with Clozaril, and I wouldn't recommend it to someone who doesn't have a severe and treatment-resistant psychotic disorder.

Edited by Hadeharia
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Clozaril is worse than Zyprexa (generally) for causing weight gain. It also carries a risk of a deadly lack of white-blood cells. Hence it requires frequent blood tests and close monitoring. Like others have said, it's generally used for treatment-resistant schizophrenia. If your pdoc has said no to Zyprexa, she almost certainly will say no to Clozaril. 

 

Have you tried Risperdal?

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Clozaril worked for me when no other AP's had. I was reluctant to try it because of the side effects, especially the weight gain. I was in the hospital at the time, and they really wanted me to try  it since I had been on everything else and had auditory hallucinations for 5 years  plus paranoia. I was also anorexic at the time. I agreed to try it if they let me take Metformin to help control the weight gain. They put me on a really low dose of Metformin, but I was severly underweight and needed to gain weight. Even with the Metformin, I gained 30lbs on CLozaril, but it worked so well it was almost worth it. The voices went away, as did the paranoia. My blood pressure got really, really low, so I was lucky I was in a hospital and was able to be monitored. The Clozaril also made me really tired, so they gave me Providigal to counteract the sedation. I was so happy not to be psychotic anymore, and it helped me get over my anorexia. But the Clozaril, with all the blood tests required was a hassle. It also made me wet the bed some nights. I really hated that. Once that started, I wanted to come off it. After 6 months of taking Clozaril, I was able to come off it and switch to an AP with fewer side effects. First they put me on Risperdol, which I had been on a couple times before, and it had never worked. Post Clozaril, it worked beautifully, no return of psychosis. Had to go off the Risperdol because it increased my prolactin levels, and I stopped getting my period, so they switched me to Latuda. I had tried Latuda prior to the Clozapine as well, and it hadn't worked either. Once again, there was no return of psychotic features.

 

I would say if you're at the end of your rope try CLozaril. I wish someone had tried it sooner with me.It has a lot of annyoying side effects, but it works. Zyprexa works for a lot of people, but it does cause a lot of weight gain, less than CLozaril though. See if your doctor will put you on Metformin to keep the weight gain in check. Have you already tried Latuda? It's pretty good and causes minimal weight gain, although I haven't lost any weight on it, so I don't think it's as weight neutral as they claim. Good luck to you.

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Honestly, I don't think that anyone should go on Clozaril unless it's absolutely necessary. It's meant to be used as a last resort. I too had a bad experience with Clozaril, and I wouldn't recommend it to someone who doesn't have a severe and treatment-resistent psychotic disorder.

 

i agree...and even then...when i hit treatment resistance clozaril didn't work better for me than traditional/typical antipsychotics have and the side effects were far worse. though even those are starting to crap out on me again now so who fucking knows.

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