Posted by med_empowered on September 25, 2005, at 19:46:09
In reply to Re: CLOZAPINE - side effects » pretty_paints, posted by ed_uk on September 25, 2005, at 10:35:33
hey! I know in my previous post I was a little dismissive of neuroleptic combos but...sometimes they do help. One study I read used 20mgs Zyprexa with 15mgs Abilify. To me, this seems like overkill, but apparently the combo improves positive/negative symptoms and overall functioning in those with schizophrenia switching from high-dose conventional neuroleptic treatment (which, of course, results in much higher D2 blockade than atypical treatment) while minimizing side-effects. I think the seroquel+abilify combo could be a good call; since Abilify has a pretty high D2 occupancy compared to other atypicals (it just has a good EPS profile b/c of the dual agonist/antagonist thing), 10mgs could provide pretty substantial relief w/ minimal side effects, and the seroquel could help with anxiety, sleep, and residual symptoms...the combo could also help reduce the dosages of both meds involved, which could possibly lead to an overall reduction in side effects and medication adjustments. Zyprexa+abilify would be another alternative; I think 10mgs Abilify+5-10mgs Zyprexa, possibly with additional Zyprexa (2.5-5mgs) for as-needed use/symptom control, could be extremely helpful. Also, adding propranolol and/or benzodiazpenes can help to reduce your neuroleptic dose and reduce akathisia, tension, anxiety, and agitation. I imagine that mixing a typical with an atypical could be helpful; if done *very* carefully, you could get symptom reduction but keep the benefits of using atypicals. Loxapine is kind of atypical-ish, so it might be a good call...perphenazine, particularly in Triavil, could be a nice, relaxing add-on. Good luck!
poster:med_empowered
thread:559067
URL: http://www.dr-bob.org/babble/20050921/msgs/559568.html