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Pdoc today. Any help? Retry clozapine?


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I see my pdoc in a few hours. She just upped my Prozac to 20 mg not quite a week ago.

I had a few good days then my mood has tanked again, unfortunately. Also, some troubling thoughts have been on my mind like the monitoring from the government and some messages from the universe.

Do I just wait things out or ask for a rexulti increase? I’m taking 2 mg rexulti currently and I know my pdoc wants me at 4 mg. She has pushed for this before. The thing is I don’t know if I need it or not and should just wait and see if the Prozac helps in like 4-7 more weeks?

Edited by Wonderful.Cheese
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the prozac increase might help your mood, but i don't think it's likely to help with the thoughts of government tracking and the messages from the universe. tinkering with your AAPs would probably be more helpful for those issues.

do you think you would be okay waiting for prozac to kick in? four to seven weeks can seem like an eternity when you're in the pit. if your mood has tanked, i'm concerned that it would be very hard on you to wait and hope for things to get better. how often do you see pdoc? waiting might be okay if you feel like you could maintain decent quality of life between appointments. i just don't want to see you get stuck really far down and not be able to see pdoc for a long time.

if you decide to try changing your AAPs, i'd probably try increasing rexulti first, though i understand your hesitation about getting worse side effects. it just seems like it would be a little easier to change that dose than to completely switch meds again. you can always go back down if your sleep gets worse, or if it doesn't help. how have you liked rexulti at this dose?

would you be wanting to swap rexulti for clozapine, if you go that route instead? i think it might be worth another shot, but with a much slower titration this time. i seem to recall that any benefit you got from clozapine was pretty much immediately outweighed by the side effects. would the cost of the blood draws be manageable? i remember that was hard on you too when you were taking it before.

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I think trying clozapine at a lower dose is a good idea.  Hopefully you could drop the number of AAPs you're on.  And, I think it is good for mood as well.  I agree with echo, I think you need something to better control the psychosis/monitoring and I think clozapine could really help.

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Well. Pdoc kind of took the lead right off the bat. I didn’t feel brave enough after that to bring up the idea of upping rexulti even nor asking about clozapine not that option for sure!

Since my afternoons and evenings are worse (she asked when was worse), I’m to take my 2 mg rexulti in the afternoon 1-2 pm to help get me through my later parts of the day. So that’s all that happened. Uneventful.

ETA: I took my rexulti about 20 mins ago maybe now and I am so damn calm unbelievable it’s amazing and

 

i am loving this feeling! My whole body is jus t so relaxed. Everything feels so good! I don’t why I was wasting this as a bedtime med.  I am not tired either jus t. Calm. Amazing!

Edited by Wonderful.Cheese
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  • 1 month later...
On 11/18/2019 at 11:37 AM, Wonderful.Cheese said:

Do I ask to retry clozapine but at a much lower dose like no more than 150 mg - 300 mg? I was up to at least 600 mg before and we overshot the dose and that’s why I had bad side effects. 

When you say bad side effects, do you mean stuff like weight gain, sedation, drooling, etc. Or the black box warning type stuff (seizure, agranulocytosis, endo-/myo-/pericarditis, etc.)? 

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