Posted by med_empowered on September 24, 2005, at 17:15:39
In reply to CLOZAPINE - side effects, posted by pretty_paints on September 24, 2005, at 16:41:58
hey! Don't despair :-) One option, although not done terribly often, would be adding a stimulant to the antipsychotic. LOW-DOSE stimulants can actually help with the negative symptoms of psychiatric disorders, and would presumably have an anti-depressant effect of sorts. Although in the past low-dose Ritalin and Dexedrine were used for this, Provigil would probably be a good option these days; its gentle, there's some data indicating it helps with cognition, and the risk of inducing psychosis/worsening positive symptoms is lower than with the old-school stimulants. As for weight gain...I don't know about clozapine, but with zyprexa there's some indication that co-prescribing Meridia (sibutramine) and presumably other, older drugs, helps significantly with the weight gain. I also seem to recall some studies showing co-administration of some anti-diabetes drugs helped both with the weight gain and with the metabolic weirdness that so often accompanies atypical antipsychotic usage. Are you actively psychotic right now? Cause, if you're not, your doc should probably lay off RXing an add-on antipsychotic...combining antipsychotics is increasingly popular, but there really isnt any good evidence that it helps anybody (except drug companies). Also, although back in the day it was considered really important to either induce pseudo-Parkinson's or reach a "therapeutic dose," informed docs these days realize that the important thing with antipsychotics is *improvement*, not dosage, and it takes a while to adequately *sses the effectiveness of any dose of an antipsychotic. Finally, I don't know what exactly you're taking antipsychotics for, but you might want to consider adding a mood-stabilizer--it helps a lot of people with "moody" schizophrenia, bipolar disorder, and even those who appear to have relativley "classic" schizophrenic symptoms. Tegretol is a classic addon, but Trileptal would be much better tolerated; Lithium is still used, but it does terrible things combined with some antipsychotics (ex: haldol+lithium=brain damage, possibly death). Benzos aren't usually co-prescribed with Clozapine, but I think opinion on that might be changing...ativan (lorazepam) and klonopin (clonazepam) are both pretty popular for psychosis and mood-stabilization; xanax (alprazolam) and valium also are of value in depression. Good luck!
poster:med_empowered
thread:559067
URL: http://www.dr-bob.org/babble/20050921/msgs/559078.html