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How does this work? I'd like to get off some of the AAP's I'm taking and have zyprexa zydis as a PRN. (It was/is my miracle med but it was discontinued due to extreme weight gain)

However, how does a person know when to take one? I don't understand this concept. 

Every time voices are heard? Every time you get a message on the TV or radio from the universe regarding timelines? Every time you feel people are going to really hurt you or are watching you or are stealing from you or your brain? Etc?

If that were the case I'd be taking one more often than daily.

And then when do you stop taking the PRN AAP?

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9 hours ago, melissaw72 said:

Idk if this helps, but I have heard of people taking zyprexa as needed, for when they start to feel symptomatic, and taking it for a day or maybe 2, it stops it in its' tracks.

Thanks Melissa. That helps me get a better idea of what this might be like. 

I think this might not work so well for me. (AAP as a PRN) But maybe I would just need to learn when to take one. I think I'd be taking it daily or nearly daily anyway. But maybe I could learn. 

I'd like to trim my meds down though so bad. Pdoc doesn't seem interested in doing that though. Husband wants no changes as well. :( I feel very stuck in an over medicated mess.

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1 minute ago, Wonderful.Cheese said:

Thanks Melissa. That helps me get a better idea of what this might be like. 

I think this might not work so well for me. (AAP as a PRN) But maybe I would just need to learn when to take one. I think I'd be taking it daily or nearly daily anyway. But maybe I could learn. 

I'd like to trim my meds down though so bad. Pdoc doesn't seem interested in doing that though. Husband wants no changes as well. :( I feel very stuck in an over medicated mess.

I'm sorry you feel stuck with meds.  Sounds very frustrating.

Can you tell when things start to feel more out of control than how you usually feel in general? 

If yes, for example ... that would be when I would take it (IMO) because it will stop you from becoming worse than you usually feel.  If that makes sense.

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38 minutes ago, melissaw72 said:

I'm sorry you feel stuck with meds.  Sounds very frustrating.

Can you tell when things start to feel more out of control than how you usually feel in general? 

If yes, for example ... that would be when I would take it (IMO) because it will stop you from becoming worse than you usually feel.  If that makes sense.

Good food for thought, Melissa! Thanks again! You are always so helpful! I will do some thinking this weekend and try to call my pdoc on Monday. Something has to be done. 

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I don't think I could make do with taking an AAP as a PRN, just personally. I lose insight really quickly and I know I wouldn't take my PRN as needed. It seems to me you need to be really good at identifying early symptoms if you're going to take this route. Not saying it's the wrong thing for you, just that for me personally I know it wouldn't work. 

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I used it for agitation not psychosis and the zyprexa kinda helped but it's hard to walk the line of being over medicated. I still have Thorazine PRN but that's for special circumstances, and I guess it's all about what ur trying to treat 

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What I have found to be more effective is to take an AAP consistently at one dose and keep tablets/capsules of a smaller dose to "top-up". For example, I take loxapine 25mg at bedtime, but every once in a while I have breakthrough symptoms so I take an additional 10mg capsule for 2-3 days then go back down to my usual 25mg dose. That usually squashes it and I don't have to think about it again. However, if I do that and I find that I don't re-adjust when I come back down to 25mg, then it's probably time for a dose increase.

Loxapine is a good medication because the 25mg and 50mg capsules can be taken for maintenance and the 5mg and 10mg capsules can be used PRN. But an antipsychotic PRN is different from a benzo PRN. With benzos, you take them when you have symptoms. But with antipsychotics, a single dose usually isn't enough to squash an episode unless you're taking a really high dose or are getting an intramuscular shot. PRN for antipsychotics typically means a stretch of a few days of consistent dosing and then going off of it

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AAPs are not very good as PRN mania/psychosis management drugs. Even oral 1st generation APs aren't that effective at quickly knocking out episodes. The IM versions are more effective, but also tend to cause lots of sedation, which just dulls you out. This may be a good thing during an intense episode, but it doesn't treat the underlying problem. I would expect "PRN" use of an AAP to last for several days, assuming it's a drug that is rapidly absorbed and has a short/moderate half-life. Long half-life drugs would be useless.

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44 minutes ago, dtac said:

AAPs are not very good as PRN mania/psychosis management drugs. Even oral 1st generation APs aren't that effective at quickly knocking out episodes. The IM versions are more effective, but also tend to cause lots of sedation, which just dulls you out. This may be a good thing during an intense episode, but it doesn't treat the underlying problem. I would expect "PRN" use of an AAP to last for several days, assuming it's a drug that is rapidly absorbed and has a short/moderate half-life. Long half-life drugs would be useless.

Zyprexa has been an AMAZING PRN for me. It's by far the most effective medicine in my arsenal, and I most certainly do not need to take it every day. That said, I respond to it extraordinarily well. YMMV. It works equally well with mania/mixed and psychosis for me.

I have pretty good insight these days, however, and not everyone does. Only pure delusions befuddle me for long. Even so, it can be hard to get to your Zyprexa bottle in the closet when there's a bobcat that wants to maul you in there. You may realize it's not real, but you can't go in just the same. 

Over and over again, I hear how people here respond amazingly well to Zyprexa. It works very fast and efficiently, but it has one of the worst side-effect profiles of any psych med out there. If you are one of the lucky ones who responds really well to it, PRN usage may be a very effective way of managaing your MI. I wish I had a complementary drug for depression. 

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1 hour ago, dtac said:

AAPs are not very good as PRN mania/psychosis management drugs. Even oral 1st generation APs aren't that effective at quickly knocking out episodes. The IM versions are more effective, but also tend to cause lots of sedation, which just dulls you out. This may be a good thing during an intense episode, but it doesn't treat the underlying problem. I would expect "PRN" use of an AAP to last for several days, assuming it's a drug that is rapidly absorbed and has a short/moderate half-life. Long half-life drugs would be useless.

This is why loxapine is a good PRN. The parent loxapine has a half-life of 9 hours making it good for PRN, but its metabolites have half lives of 25-35 hours which allows a medication with such a short half life to only be taken once daily if it is taken regularly. This is why the 25mg and 50mg capsules are good for maintenance, because with them you can build up levels of the metabolites over the course of a week for maintenance but its also effective usually within an hour even at the 10mg dose.

2 minutes ago, Flash said:

Zyprexa has been an AMAZING PRN for me. It's by far the most effective medicine in my arsenal, and I most certainly do not need to take it every day. That said, I respond to it extraordinarily well. YMMV. It works equally well with mania/mixed and psychosis for me.

I have pretty good insight these days, however, and not everyone does. Only pure delusions befuddle me for long. Even so, it can be hard to get to your Zyprexa bottle in the closet when there's a bobcat that wants to maul you in there. You may realize it's not real, but you can't go in just the same. 

Over and over again, I hear how people here respond amazingly well to Zyprexa. It works very fast and efficiently, but it has one of the worst side-effect profiles of any psych med out there. If you are one of the lucky ones who responds really well to it, PRN usage may be a very effective way of managaing your MI. I wish I had a complementary drug for depression. 

Going along with what I said above, the way that I use loxapine dosing regularly at 25mg and taking an extra 10mg when needed....the only other AAP I could successfully do that with was Zyprexa. I would have loved Zyprexa had it not made me gain mondo weight and dyslipidemic

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