Posted by softheprairie on April 8, 2009, at 17:26:36
In reply to Re: anyone ever want a dose of haldol prn??, posted by Incubusfan on April 8, 2009, at 10:57:08
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> > Zyprexa Zydis dissolves in one's mouth and is an expensive prn med that decreases anxiety/agitated depression quickly. I take a cheaper old antipsychotic, perphenazine, at night plus prn. My prn use of it is mostly during crying spells. I think the Zyprexa Zydis would give you more of a HAMMER hit to the anxiety, but I have type 2 diabetes and am poor, and take the perphenazine anyways, so I'm content enough for now with the perphenazine. Oh, I also have the aid of a beta blocker, nebivolol, which helps anxiety, and I've gotten approval (after specifically asking) from my dr. to take it occasionally prn, although haven't yet. (I am thinking of it especially for when I have a racing heartbeat or heart palpitations.)
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> What dose of perphenazine do you take, and how many times a day? 4mg feels like a sugar pill to me.
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> Thanks!
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>My psychiatrist has pretty much let me decide on its dosing.
I had been at 8mg a day, plus prn. I think for prn I usually take 8 mg; if not too bad maybe just 4 mg. Some of what keeps me from going higher in dose or using more often as prn is that I find it sedating, and I already suffer from excessive tiredness. Also, I wonder if taking more and then sleeping could give me some respiratory depression? I have pretty bad sleep apnea as it is, and always sleep w/ CPAP, and don't want my breathing to get worse. I read when I was trying Ativan that it wasn't recommended for someone w/ sleep apnea to take the Ativan soon before sleep. Ativan didn't help me anyways, (at 0.5 mg three times a day) so I tapered off it. Plus, I think the EPS and TD risks on perphenazine are higher at higher doses, so that's a part of my hesitation in going higher.
Anyways, I said I had been on 8 mg, I think I used to split it 4 mg at getting up and 4 mg at going to bed, but then moved it to all at night to try to get more energy during the day. Then, after reading a book that I could predict would do this to me, a book very much against psych meds, I got scared and wanted to try tapering off of the perphenazine (but I still wanted to keep my other psych meds). I went right down to just 4 mg at night, but then I felt my mood worsening. I think it was my pdoc who suggested I get a pill splitter and move more slowly, taking 6 mg at night (4 mg times 1 and a half pills). I did that and have changed my mind about stopping the med. For now I'm staying on it at the 6 mg at night, plus 4 or 8 mg occasionally prn (I think my pdoc would be fine if I wanted more.)
I understand when you say the 4 mg just feels like a sugar pill. I don't always get much relief from the 8 mg prn. One can definitely go higher. I entered perphenazine and (dose OR dosing) into a search engine and got some mildly relevant hits, but the ones I looked at were all about on-label dosing, so for psychosis or nausea. In a hospital, one can officially go to 64 mg a day, spread out a few times, it looks like. I think it was only recommending up to 24 mg at home, and even then to try to taper down after psychosis is over. I didn't see any refernce to maintenance dosing off-label (although I didn't look for too long).
I only took the Zyprexa Zydis once (while in the hospital, and it was off-label there as well), but I was really impressed with its power to make me chill out quickly. I've seen on this board also how quickly it can help to reduce suicidal thinking. That's powerful. What really bites, in my opinion, is that any chill pill I know of also is sedating.
poster:softheprairie
thread:888359
URL: http://www.dr-bob.org/babble/20090408/msgs/889525.html