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I have a weird reaction to atypical antipsychotics. I used to find them very helpful, but this past year they started creating almost OCD-like intrusive, bizarre, racing thoughts. I've literally tried almost all of them with the same result; never had this issue before. The only one that didn't cause as much of an issue was Risperdal, but I don't find that to be fast acting or "PRN" the way others can be.

I'm currently taking 0.5 mg of Klonopin up to three times a day as needed, and it definitely helps. But there's still some "thought salad" and racing, tangential thinking going on that I really wish something like Zyprexa could fix. But last time I took it, I had a full-blown panic attack that ebbed and flowed for three hours. My psychiatrist is aware, and we've settled on mood stabilizers to manage my disorder, but I'd really like something besides a benzo to help quiet my mind. I'm thinking of asking for Haldol; one time in the emergency room I was given 5 mg of the stuff and it was the most at peace I've ever felt. Granted I was in the worst mixed episode ever.

But I guess I'm just curious what works for y'all, or if you can relate to my experience at all. Thanks for reading.

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On 4/30/2020 at 8:32 PM, mjs190 said:

I have a weird reaction to atypical antipsychotics. I used to find them very helpful, but this past year they started creating almost OCD-like intrusive, bizarre, racing thoughts. I've literally tried almost all of them with the same result; never had this issue before. The only one that didn't cause as much of an issue was Risperdal, but I don't find that to be fast acting or "PRN" the way others can be.

I'm currently taking 0.5 mg of Klonopin up to three times a day as needed, and it definitely helps. But there's still some "thought salad" and racing, tangential thinking going on that I really wish something like Zyprexa could fix. But last time I took it, I had a full-blown panic attack that ebbed and flowed for three hours. My psychiatrist is aware, and we've settled on mood stabilizers to manage my disorder, but I'd really like something besides a benzo to help quiet my mind. I'm thinking of asking for Haldol; one time in the emergency room I was given 5 mg of the stuff and it was the most at peace I've ever felt. Granted I was in the worst mixed episode ever.

But I guess I'm just curious what works for y'all, or if you can relate to my experience at all. Thanks for reading.

The Brief time I was on haldol it really helped quiet my mind too. I was prescribed 5 mg , three times a day. But I guess I’m lucky because zyprexa zydis really helps me and fixes a lot of what you list. I would say it couldn’t hurt asking to try haldol especially if it’s PRN, unless I’m misunderstanding. Either way, since your pdoc is aware you have a bad reaction to AAP’s, he/she should be more willing hopefully to listening to you when you say you tried haldol in the past and it helped you out a lot. I would hope so anyway. Good luck to you. 

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  • 2 weeks later...
On 4/30/2020 at 10:46 PM, Iceberg said:

If your going the typical AP route, I’ve had great luck with Thorazine got potent sleep induction. Both Thorazine and haldol make lots of docs nervous though

Yeah my doctor briefly teetered on trying Haldol but Trilafon didn't work well for me so we settled on a re-trial of Risperdal and its actually working really well. Fingers crossed.

 

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46 minutes ago, mjs190 said:

Yeah my doctor briefly teetered on trying Haldol but Trilafon didn't work well for me so we settled on a re-trial of Risperdal and its actually working really well. Fingers crossed.

 

I never got any sedation help with trilafon even at crazy doses. Doc was trying to use it as my main AP and we kept going up and up and up and nothing.

curious - what risperdal dose? 

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20 hours ago, Iceberg said:

I never got any sedation help with trilafon even at crazy doses. Doc was trying to use it as my main AP and we kept going up and up and up and nothing.

curious - what risperdal dose? 

I was on 2 mg but it felt like too much. And 1 mg was fine, but everything feels best at 1.5 (1 mg in the AM and 0.5 mg at bedtime).

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There is another member here who has OCD symptoms specifically from clozapine. It's a definite thing that happens with the atypicals, most commonly clozapine.

My experience with FGAs are the following...

Stelazine is by far my favorite antipsychotic in general I think, but definitely my favorite FGA. It has worked absolutely fantastically for me in the past. It's a far greater alternative to Haldol for me—far lower rate of side effects, especially EPS, emotional flattening, etc.; works better for anxiety for me than Haldol; actually improves depression, as well as "brightens" mood, somehow; kind of has a pro-cognitive, "brain glue"-like effect for me; and while I was taking it regularly, I was probably the most chill I've ever been in my life, and I think that positively impacted my ability to make decisions confidently for the first time in my life. It was a bit sedating after a while when I was on 2 mg tid regularly though, which is the usual max dose for anxiety. I have 5 mg tablets available to me now that I can take up to 2 of per day.

Loxitane helped me get through one of the worst psychotic depressive episodes I've ever had. 5-10 mg/day was the dose I was on. <20-25 mg is supposed to behave more like an atypical antipsychotic.

Trilafon literally did nothing for me, good or bad.

Prolixin was equally as, perhaps more, worthless as/than Trilafon.

Haldol had too many side effects to justify taking it even as a PRN at any dose. Other things were more effective for what I was taking it for at the time.

Thorazine was okay at 100 mg for insomnia for a while, but stopped working as well. Any less wasn't effective, any more made me have horrendous nightmares. Also, the first time I took it (I took half a 100 mg tablet), I had an acute dystonic reaction.

Compazine is really only good for nausea, at least at the doses I've tried it anyway.

Orap was mildly beneficial for my Tourette's disorder at 4 mg/day for a short time, then my tics came back after a few weeks. Then I read about just how freaking dangerous it is for the heart and jumped ship.

Navane is mildly effective for sedation and mania at 2 mg up to 6 mg/day, but I kinda get the same emotional flatness from it that I get from Haldol. Something about it makes me just feel "off..."

I think literally the only FGAs I've not tried are Mellaril and Moban (whether Moban is actually even available in the US still is questionable, my insurance likes to pretend that it is but also likes to pretend that it's a tier IV non-preferred brand-name medicine even though it's generic only).

 

Just a note that the brand new SGA/AAP, Caplyta (lumateperone), just recently came out. It's what I take now and it has been a literal lifesaver. If you don't already know about its pharmacodynamics, it's a presynaptic D2 partial agonist/postsynaptic D2 antagonist, an SSRI of about equal binding affinity to D2 binding affinity, a very potent 5-HT2A antagonist, and an indirect releasing agent of glutamate via activation of D1 receptors. Oddly enough, it's a butyrophenone like Haldol. Not sure if you would want to give that a try before committing to a FGA.

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