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  • 2 months later...

@Butterflykisses I am currently on 10mg of loxapine all at night. I like it very much. First antipsychotic that doesn't make me blow up like the Michelin man, increase my triglycerides and blood sugar, or turn me into a zombie. How has it been going for you? Going into summer I've been thinking about talking to my pdoc about going up to 20-25mg.

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@Butterflykisses My doctor and I talked about clozapine, but I was concerned about the side effects, especially the agranulocytosis. That's scary stuff. However, I think that's why my doctor put me on loxapine in the first place. I responded well to olanzapine but wasn't receptive to clozapine because of the side effects. Loxapine is structurally similar to clozapine, that is correct. But it also has a very similar binding profile to olanzapine. I started on 5mg of loxapine at night, but I wasn't totally level until I got to 10mg. However, I am taking it all at night and not 2-3 times a day like the prescribing info suggests. So I'm not having sedation issues during the day like what people experience when they take it at night as well as in the morning.

Another thing to keep in mind is that I don't have to go up all that high on loxapine because I'm taking oxcarbazepine as well. The oxcarbazepine helps to deal with a lot of symptoms that would normally only be addressed with higher doses of loxapine if I wasn't taking oxacarbazepine. And I would rather keep the antipsychotic dose as low as possible and modulate with other medications instead. So far, that attitude has gotten me pretty far. My trials with antipsychotics would only get so far until symptoms were BARELY managed at therapeutic doses but the side effects were intolerable. It wasn't until we introduced a more calming anticonvulsant to replace Lamictal that I finally was able to manage my symptoms without full therapeutic doses of antipsychotics. Lamictal just wasn't calming enough.

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