Posted by yxibow on March 16, 2009, at 2:07:43
In reply to Antipsychotics? All the same?, posted by Cseagraves on March 14, 2009, at 17:24:09
> Hi guys!
>
> Just some opinions needed. Not that I need one now, but thinking about a back up plan if Zoloft doesn't work. Someone gave some advice on a post about adding an antipsychotic to your ssri if needed. When you take both of these together, how does that work? I've taken them seperately, but never together for anxiety. My pdoc at the time kept trying to raise my dosage of the Seroquel. He got it up to 400mgs daily, which did quiet down my brain, but it never got rid of the anxiety.
>
> Have taken Seroquel before, didn't like it. Made me feel awful. Had all of the awful side effects while on it. Not sure of the names of all the rest. (Zyprexa, Ambilify, Geoden)? I'm sure there are others I don't know.
>
> Are they pretty much all the same or are some milder than others?
>
> Another question. Knowing that everyone is different, I just want an opinion. Do you think mixing an ssri with an antipsych med for extreme GAD would be better, or would you think an maoi would work better.
>
> I know nothing will be as easy, but would like to spare myself as much torture as possible. :-)
>
> Just curious,
>
> Thanks,
> CourtneyNo, making an informed choice about using an AP for an augment or other purpose is not an easy thing.
Basically, at least in my opinion the relative strength at maximum dose would be
Risperdal/Invega->Geodon/Abilify->Zyprexa->Seroquel/(Seroquel XR), with *Clozaril in its own category.
But that's just my experience with side effects, in fact Zyprexa did a number on me, but I'm terribly sensitive to APs.
I have and currently take Seroquel.
Generally the best strategy is the MED (minimum effective dose).
I guess my scale is more rated on relative side effects, e.g. mostly EPS symptoms such as akathisia.
It doesn't mean that Zyprexa, for example isn't necessarily not strong for some people as it has a fairly strong effect at D2 but not other transmitters. But it "lets go" faster than Risperdal would.
I guess what I'm saying is that there are liabilities, but there is also a benefit for strong anxiety, especially personally I think with Seroquel.And yes, Seroquel and Risperdal and Zyprexa at least, do have effects on lipids and weight. Its difficult. Its also probably dose dependent to a degree.
For me, Geodon was I think the strongest at akathisia, and Risperdal was very strong with negative nightmare and other odd effects, as well as causing a slight tic (its still there, but then like I say, I'm probably not a typical example of how people react to APs).
In general though I'd say that regardless of studies pointing to general effectiveness with psychosis, atypicals are much safer (with their own weight issues, yes) than typicals (which aren't perfect either -- Mellaril is still around and it has more heart problem potentials than Geodon).
Hope that helps
-- Jay
poster:yxibow
thread:885316
URL: http://www.dr-bob.org/babble/20090313/msgs/885586.html