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Re: AP's and relief

Posted by undopaminergic on March 23, 2020, at 12:18:45

In reply to Re: AP's and relief, posted by Lamdage22 on March 23, 2020, at 7:16:03

> Sedation and Weight Gain (Although i can now fight it). And weird dreams. Some people go from skinny to XXL in a matter of weeks. Not healthy. I do take Metformin for this, but it doesn't work for everyone.

Very common with most atypicals. But not all of them are as strong antihistamines as Seroquel and Zyprexa. Indeed some of them have negligible affinity for the histamine H1-receptor.

Have you considered amisulpride (or sulpiride; maybe tiapride), lurasidone, blonanserin, sertindole, or cariprazine?

The "old-style" APs also cause less weight gain, although they are more likely to provoke the antipyramidal side effects. Some examples of typicals with low histamine H1-affinity are haloperidol, thiothixene, perphenazine, trifluoperazine, and fluphenazine. At least some of these, such as haloperidol, are very effective APs.

My psychiatrist thinks Seroquel is a poor antipsychotic. A nurse I've spoken with is of a similar opinion. It is also *very* antihistaminic -- only clozapine has a higher histamine H1 affinity relative to dopamine D2.

What all APs have in common is the D2-antagonism. Clozapine is the mildest at the D2, yet it is regarded as the most effective. It is the preferred AP for psychosis in Parkinson's disease.





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