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I'm either schizoaffective bipolar type or bipolar 1 with psychotic features and I've been hearing voices and having paranoia for the past 3 weeks. 

My pdoc increased my latuda but I highly doubt it will help. 

Effexor XR 150mg 

Depkote ER 2250mg 

Latuda 120mg 

Trazodone 100mg 

I've tried Abilify and Seroquel. So that leaves Geodon, Zyprexa, Saphris, Vraylar, Rexulti, Risperdal, and Invega. I basically refuse try Saphris and Zyprexa because of the weight gain. Depakote has already made me gain a considerable amount of weight. I guess the Geodon is pretty similar to the latuda so that wouldnt be a first pick. I really lost right now and freaking out because I used to not notice the voices anymore but they just keep getting worse and worse and worse.

Edited by tbs14

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Latuda at a high dose dealt with my psychosis really well. I was on 160 mg at my highest dosage. Give it a chance, 100mg is still a fairly low dose.  

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All the AAPs can lead to weight gain and the only way of knowing whether or not it will is to try one. For instance, I never got weight gain from Zyprexa. We are all different but in terms of efficacy, I find risperidal, zyprexa, and clozapine to be the best for psychosis. 

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Saphris is actually not known for causing weight gain. It has a higher possibility than some AAPs due to its affinity for the 5-HT2C and H1 receptors, but in clinical trials, it wasn't a very prominent side effect. Saphris just tastes like ass is the only thing I remember about it. They're sublingual tablets you have to dissolve under your tongue, and you can't eat or drink anything for a certain amount of time before and after taking it.

Geoodon is similar to Latuda in that you are required to take it with food in order for it to be optimally absorbed. Where Latuda only requires to be taken with 350 calories, Geodon (which is taken twice daily usually) requires at least 500 calories per dose, and if you take it twice a day, that's 1000 calories just to absorb the medicine properly. If you don't take it with food, you run the risk of increasing chances of mania and/or psychosis. Don't get me wrong, Geodon is a good medicine in my opinion and from my experience, it's just a bit of a hassle to keep track of taking it with food. But it is very weight neutral, but probably not as weight neutral as Latuda.

Latuda can be taken up to a maximum of 160 mg/day (2x80 mg tablets). Perhaps you could talk to your pdoc about going up to 120 mg, and if that doesn't work, then going up to 160 mg? You may experience some akathisia, so be sure to ask for a prescription for Cogentin just in case it happens. If you've never experienced akathisia, it's absolute hell; if you have, then you know exactly what I'm talking about.

I'm taking Vraylar 4.5 mg right now and it's doing quite well to control my mood stability and psychosis. Abilify was working very well for me, but I was having severe impulsive buying problems with it and had to get off of it. I don't seem to have nearly as much of a problem with impulse buying with Vraylar, and while it seemed to disappear at 3 mg, since going up to 4.5 mg, it seems like it may be returning. So if you have a propensity for that sort of thing, watch out with Rexulti and Vraylar (especially Rexulti).

You also may consider discussing with your pdoc temporarily going down in dosage on your Effexor XR, like 75-112.5 mg, since you are experiencing possible mania and/or psychosis.

Edited by mikl_pls

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I don’t usualy suggest risperdal, but if you / pdoc feel like it’s time to ditch latuda, risperdal has less weight gain than zyprexa (usually) but is still very good for psychosis

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1 hour ago, saintalto said:

@mikl_pls  I do not take Latuda with food, I was told to take it before bedtime. No instructions for food from the pdoc.

That's strange that doc didn't advise you about needing to take with food.......Surprised that the pharmacist didn't inform you, either............Latuda's absorption rate can be reduced by as much as 30-50% if it's not taken with at least 350 calories.

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@CrazyRedhead If I take Latuda in the day at any point, food or no food, I throw it up. No one ever told me to take it with food, but even if I do, I couldn’t take it when there’s any light in the room or I’m moving at all. It makes me violently ill unless I’m laying down still in a dark room about to go to sleep. Seems to work for me fine, I’m stable, so I’ll just continue how I’m going. I hate the violent nausea that can happen and at bedtime is the only way I’ll keep it down. 

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1 minute ago, saintalto said:

Seems to work for me fine, I’m stable, so I’ll just continue how I’m going. I hate the violent nausea that can happen and at bedtime is the only way I’ll keep it down. 

If it ain't broke, don't fix it, as my grandfather used to say......:)........I'm glad you're feeling stable on it.

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16 hours ago, mikl_pls said:

Saphris is actually not known for causing weight gain. It has a higher possibility than some AAPs due to its affinity for the 5-HT2C and H1 receptors, but in clinical trials, it wasn't a very prominent side effect. Saphris just tastes like ass is the only thing I remember about it. They're sublingual tablets you have to dissolve under your tongue, and you can't eat or drink anything for a certain amount of time before and after taking it.

Geoodon is similar to Latuda in that you are required to take it with food in order for it to be optimally absorbed. Where Latuda only requires to be taken with 350 calories, Geodon (which is taken twice daily usually) requires at least 500 calories per dose, and if you take it twice a day, that's 1000 calories just to absorb the medicine properly. If you don't take it with food, you run the risk of increasing chances of mania and/or psychosis. Don't get me wrong, Geodon is a good medicine in my opinion and from my experience, it's just a bit of a hassle to keep track of taking it with food. But it is very weight neutral, but probably not as weight neutral as Latuda.

Latuda can be taken up to a maximum of 160 mg/day (2x80 mg tablets). Perhaps you could talk to your pdoc about going up to 120 mg, and if that doesn't work, then going up to 160 mg? You may experience some akathisia, so be sure to ask for a prescription for Cogentin just in case it happens. If you've never experienced akathisia, it's absolute hell; if you have, then you know exactly what I'm talking about.

I'm taking Vraylar 4.5 mg right now and it's doing quite well to control my mood stability and psychosis. Abilify was working very well for me, but I was having severe impulsive buying problems with it and had to get off of it. I don't seem to have nearly as much of a problem with impulse buying with Vraylar, and while it seemed to disappear at 3 mg, since going up to 4.5 mg, it seems like it may be returning. So if you have a propensity for that sort of thing, watch out with Rexulti and Vraylar (especially Rexulti).

You also may consider discussing with your pdoc temporarily going down in dosage on your Effexor XR, like 75-112.5 mg, since you are experiencing possible mania and/or psychosis.

What would be a good antipsychotic that would compliment the latuda

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14 hours ago, tbs14 said:

What would be a good antipsychotic that would compliment the latuda

Do you mean an antipsychotic to take on top of the Latuda?

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14 minutes ago, mikl_pls said:

Do you mean an antipsychotic to take on top of the Latuda?

Yes

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On 9/13/2019 at 6:18 PM, saintalto said:

Latuda at a high dose dealt with my psychosis really well. I was on 160 mg at my highest dosage. Give it a chance, 100mg is still a fairly low dose.  

Do you take it spread out 80 in the morning and 80 at night or 160 at night?

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