dancesintherain Posted February 28, 2018 Share Posted February 28, 2018 Hi all, Wanted to see whether I could get some thoughts on a possible upcoming medication change. Because I'm currently doing exposure therapy, my psychiatrist doesn't want to change meds unless absolutely critical. That said, I'm continuing to gain weight while on Zyprexa, despite trying not to, so she would eventually like to go to a more weight-neutral medication. I'm working on diet and exercise, but the hunger cravings from Zyprexa are too hard right now. I can't switch to the zydis because I can't handle dissolvables. History of attempts: SeroquelIR - huge amount of weight gain; worked well for mood stabilization and sleep needs; handled psychosis (I don't get a ton of psychosis unless I'm really deeply into an episode) SeroquelXR - got EPS of some flavor--I can't remember which; did help for mood stabilization; didn't try it at a time where I was psychotic, so don't know about that Risperdal - worked wonderfully as far as the med is concerned, but got pseudo-parkinsonian syndrome - going off of it put me into a mixed episode Latuda - did well at getting me out of a depressive state, but sent me manic and I landed in the hospital Abilify - akathisia. Enough said. I think, off the top of my head, that those are the only attempts that I've had that were serious. I was starting up on rexulti previously, but I decided to try seroquelXR instead since Seroquel had worked so well for me minus the side effects. Goals would be for mood stabilization and psychosis prevention. I tend toward the depressive side, but have gone manic previously. The psychosis, when I'm really in a bad mood state, is in the flavor of hallucinations and delusions. I'm fortunate to have good insurance, so most things would be affordable. Thanks! Link to comment Share on other sites More sharing options...
Wonderful.Cheese Posted February 28, 2018 Share Posted February 28, 2018 There is Invega (similar to risperdal though but supposedly less side effects, which I found to be true but YMMV) Vraylar Clozaril Fanapt (wasn't on it long enough to see if it worked) Geodon (weight neutral for me) Saphris (but it's a dissolving tablet, so that might be a no go. But it worked well for me but YMMV. I did gain weight though) Rexulti (as you mentioned, but it does not have the bipolar mania indication so I'm not sure how well it works on mania) And I am with you. Latuda sent me through the roof. Too bad about the Seroquel IR and especially the XR. Hope this helps! If you have further questions about my experiences with any of these let me know Link to comment Share on other sites More sharing options...
dancesintherain Posted February 28, 2018 Author Share Posted February 28, 2018 Thanks Cheese--I forgot about an invega trial. I was inpatient and they started me on it and I started listing to the left to a degree that the IP pdoc was concerned. So that one got ruled out also. And you're right that saphris is a problem because of the dissolvable aspect. I just can't do ODT things. Geodon I had tried and I can't remember if it was excessive sedation or inability to sleep, but one of the two hit me. I think excessive sedation. That doesn't leave many. I'd consider trying some again, but the EPS side effects were pretty god-awful and cogentin gave me blurry vision to the point that I couldn't read or drive (only know that it's the culprit because it went away as soon as I stopped it). I guess I'm med sensitive. Link to comment Share on other sites More sharing options...
Geek Posted March 1, 2018 Share Posted March 1, 2018 Since weight gain is an issue, it may be worth discussing with your pdoc about trying metformin in addition to an (A)AP. I've read some recent studies indicating Metformin can reduce or prevent AP-induced weight gain, especially Zyprexa. It appears to be most effective when started at the same time as the AP. I can't offer much insight/experiences with other AAPs. I've tried Abilify, Rexulti, and Vraylar as adjuncts to various anti-depressants (I don't have psychosis, so can't speak to that). Abilify seemed to help the best of the three but also caused akathisia. That did not happen with the Rexulti but it was a much more minor impact (if any at all) on my mood. I gained weight on Vraylar, though lost most of it without trying once I came off it. Vraylar had no impact on my mood, however. Link to comment Share on other sites More sharing options...
looking for answers Posted March 1, 2018 Share Posted March 1, 2018 vraylar is showing signs in 6 days of helping my mood , but obv YMMV as seen by geek Link to comment Share on other sites More sharing options...
dancesintherain Posted March 1, 2018 Author Share Posted March 1, 2018 thanks geek and looking for answers. Geek, I've gone the metformin route previously and I'm not sure it did much. For some reason, I don't know what, the hospital took me off of it. My current pdoc threw out the possibility of topamax, but didn't want to change anything now since I'm doing exposure therapy (too many variables). Thanks both of you for your feedback on how you reacted to the various drugs. Link to comment Share on other sites More sharing options...
Wonderful.Cheese Posted March 1, 2018 Share Posted March 1, 2018 31 minutes ago, dancesintherain said: thanks geek and looking for answers. Geek, I've gone the metformin route previously and I'm not sure it did much. For some reason, I don't know what, the hospital took me off of it. My current pdoc threw out the possibility of topamax, but didn't want to change anything now since I'm doing exposure therapy (too many variables). Thanks both of you for your feedback on how you reacted to the various drugs. Darn. It's too bad that Topamax and metformin aren't options. I'm no pdoc but if zyprexa is really working well for you is that totally out of the question as an option? To try those meds? They have really helped me actually lose weight on zyprexa. But I totally understand why they might not be options if your pdoc has said so at this time. It's just too bad because it seems like a lot of other AAP's have been tried too. Do you think changing your AAP will be hard during exposure therapy? I hope that that won't rock the boat too much. But I understand that a change needs to happen. The timing just stinks. Sorry you are going through this. Ugh. Sending good thoughts. Link to comment Share on other sites More sharing options...
dancesintherain Posted March 1, 2018 Author Share Posted March 1, 2018 Barring an emergency, nothing changes during exposure therapy...so even the conversation about AAPs themselves is me planning ahead rather than right now. Topamax could go on the table in the future when med changes are back on the table. I’m just reluctant because I hate taking more meds to counteract more side effects. Part of the beauty of this most recent hospital stay was getting rid of a lot of excess. Link to comment Share on other sites More sharing options...
looking for answers Posted March 2, 2018 Share Posted March 2, 2018 Vraylar Link to comment Share on other sites More sharing options...
dancesintherain Posted March 12, 2018 Author Share Posted March 12, 2018 For those who know the differences between the pharmacology of the various AAPs (I don't understand such things), what's the closest to Risperdal or Zyprexa? Those are the two that have worked the best for me, but for the side effects. Link to comment Share on other sites More sharing options...
Iceberg Posted March 12, 2018 Share Posted March 12, 2018 Invega is closest to risperdal, one is actually just a metabolite of the other. I would say (maybe?) clozaril is pretty close to zyprexa at least in effect but I'm not 100% on that Link to comment Share on other sites More sharing options...
dancesintherain Posted March 12, 2018 Author Share Posted March 12, 2018 Thanks--sadly invega's off the table because of neuro side effects (it caused me to list uncontrollably to the left). Do you know what's closest to seroquel? (if anything) Link to comment Share on other sites More sharing options...
Recommended Posts