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Which is considered the most potent AP?


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I don't have psychosis, so this is mostly out of curiosity.

What AP is considered the absolutely most potent one for psychosis? Feel free to include typicals as well, I just thought I'd post it in this forum since it's bigger.

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Ok, I'll look Clozaril up.

I'm asking because I have a friend (no really, a friend ;) ) that is psychotic and she is currently on Trilafon, which I think is considered quite "heavy" but it's only working halfway.

She's tried Zyprexa and Risperdal but none of them worked.

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I think it depends on what strong means.  There are low potency meds which you can take a high dose of and high potency meds which you don't have to take that much.  Risperdal is considered pretty potent.  I have tried Trilafon and I thought it was much more sedating than Haldol.  I am back on a low dose.

Katie ;)

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Heya,

Yah it depends on the symptoms you're chasing after -- for psychosis, that could be posiutive or negative symptoms, moods, impulse control, paranoia, all the flavours -- and the s/e you're willing to tolerate (higher risk of EPS vs. higher risk of weight gain, for example).

I'm looking around for references.  The literature is fairly contradictory.  Partly b/c people in the studies (hey, we're all just people, in a study or not) keep quitting their meds.

So nothing really intelligent here.  I like Seroquel, but I don't have any reason for that except clinical feedback from patients, and we *all* know how scientific *that* is! 

;)

FYI we use Haldol (and, increasingly, Zyprexa) a whole bunch in acute situations b/c it's available IM (intramuscular), i.e., a quick jab in whichever muscle you can get at.

Clozapine is considered I guess halfway between "typical" and "atypical," and I've been told I haven't tried hard enough (as a doc) with the atypicals until I've tried clozapine.

--ncc--

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She doens't have schizophrenia, so I'd assume it would be called Psychotic Disorder NOS or something? I think positive symptoms are the main concern here. Especially hearing voices.

I think any side effects wouldn't really matter as long as the voices stop. Side effects you can live with (most of them) but hearing voices constantly picking on you is another story.

Thanks for the input guys. Hopefully it will be of some help, even though her crazy doctor is very hesistant about trying new meds.

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I don't have psychosis, so this is mostly out of curiosity.

What AP is considered the absolutely most potent one for psychosis? Feel free to include typicals as well, I just thought I'd post it in this forum since it's bigger.

<{POST_SNAPBACK}>

I take clozaril.....200 mgs at bedtime.  I have been as high as 600 and as low as 50. I have been on it for about 3 yrs. 

It really helps with the "white noise" in my head, and helps me think more clearly.  I don't hear voices per se....  Just major distorted thinking.

I also take it for suicidal ideation........something that it has been recommended for ........ so far so good...... ;)

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Yeah I guess dosage range is pretty important. I mean, I am on seroquel which is considered to be the "weakest" ap, but my dose is 1500mg/day which is high - i think the average is 400-800mg.

Zyprexa is a strong one - maybe not as "strong" as some of the old school ap's, but given dosage ranges it would have to be up there.

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I think it varies from person to person.

I'm on 20mg of Zyprexa which is the highest dose used in the UK, and it calms the full mania and some psychosis but does jack all for hypomania and the rest of the psychosis.

The addition of 200mg chlorpromazine/thorazine has killed the voices and the hypomania. And all the crap out of my head....I love chlorpromazine.

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