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a carousel of SGAs/atypicals?

Posted by Snell on October 25, 2013, at 7:11:06

Does anyone else need to keep changing SGAs? (When I say SGAs, I mean second-generation antipsychotics, also called atypical antipsychotics.) A lot of us, bipolar and non-, take them for (1) augmentation of antidepressants; (2) stabilization of mood; (3) sometimes the sedating SGAs can help sleeping. At least, that's why I take them. I don't have psychotic symptoms, but (4) many of us also take them to treat psychotic symptoms, both "positive" and "negative."

For me, there seems little predictable pattern to how these things work. Seroquel (quetiapine) has for me always been the dependable worker, and great, in high doses as a drug for "I'm-overwhelmed-I-just-need-to-sleep!" But it had the common side effect of making me crave sugary carbohydrates, and I gained 40 lbs. while on it. My pdoc, therefore, said: "You may *never* take Seroquel again." Zyprexa was much the same as Seroquel. Abilify gave me that zombification that the old-line antipsychotics were famous for--a boxed-in feeling, an inability to think, an inability to form an intention--as if my mind had a ball and chain attached. A vile sensation, and I came to understand why people disliked psych hospitals so much, once--because of the use of those ball-and-chain drugs such as Thorazine (chlorpromazine) and Haldol (haloperidol.) But I digress.

The SGAs that have been released more recently, Saphris (asenapine), Fanapt (iloperidone) and Latuda (lurasidone), have been great for me. None has made me gain weight. Fanapt, in particular, augmented my then-antidepressant Effexor and stabilized my mood nicely, for a year. And *that* was the longest. Saphris worked so well at first I felt quasi-euphoric, but it lasted only three months. Latuda never worked too well, but even its anemic response only lasted about three months.

There's another one, not yet available in the U.S.--Solian? (amisulpride)?

So my question is this. If this class of drug works for you for (1) augmentation of an AD or (2) mood stabilization, do you have to keep changing them to get those salubrious effects? And which ones have worked the best and the longest? --Snell


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poster:Snell thread:1052977
URL: http://www.dr-bob.org/babble/20131025/msgs/1052977.html