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Posted by Jeroen on December 11, 2004, at 13:48:49
In reply to Re: IM AFFRAID TO TRY CLOZARIL!!!, posted by linkadge on December 11, 2004, at 13:35:19
hi thanks, what about low white blood cells? isnt that dangerous?
Posted by TomG on December 11, 2004, at 15:19:55
In reply to Re: IM AFFRAID TO TRY CLOZARIL!!!, posted by Jeroen on December 11, 2004, at 13:48:49
I have done pretty extensive research on sedation and antipsychotics, because I myself am looking into changing my AP due to sedation. Unfortunately, I hate to tell you that Clozaril is the second most sedating atypical AP next to Zyprexa. I read stories from some that they thought it turned them into zombies. Sedation from antipsychotics is thought to be caused by the affinity of the drug to the H1 histamine receptor. This sedation is sometimes desirable in schizophrenia patients who are agitated. The sedation with me is not needed however. It is interfering with my daily life and to some degree my mood and drive. Seroquel is actually the next to last in terms of the affinity for the H1 receptor, but it is a high dose low potency AP so much more of the drug is needed to get a response. Many people find Seroquel sedating because they have to take a large amount to get a response and much more of the drug is reaching the brain. Abilify was not covered in the research that I read, but I have heard from many that it can be non-sedating and even activating. Also the older Haldol and Orap have an extremely low affinity for the H1 receptor. They are also high potentcy low dose AP's, but it is not unheard of that they can indeed cause some sedation. I will be switching from Geodon to low dose Abilify on Monday. If you have any alternatives other that Clozaril I would definately explore them if you are worried about sedation. Clozaril is very effective for psychosis, but it is often reguarded by docs to be a last ditch AP.
Posted by Jeroen on December 11, 2004, at 15:28:14
In reply to Re: IM AFFRAID TO TRY CLOZARIL!!!, posted by TomG on December 11, 2004, at 15:19:55
ill give zyprexa a last try before i take clozaril... maybe i should go as high as 30 mg, geodon caused that my eyes are blinking im 3 weeks off it, also im sensitive to lights
im falling into depression because of unknown thing is happening to my eyes because of geodon
Posted by TomG on December 11, 2004, at 15:36:21
In reply to Re: IM AFFRAID TO TRY CLOZARIL!!!, posted by TomG on December 11, 2004, at 15:19:55
Sorry to tell you again, but Zyprexa is leaps and bounds ahead of all other AP's in terms of the affinity for the H1 receptor. I haven't talked to many on this board who didn't find it at least a little sedating. You may be an exception, but like I said there are other alternatives if you are easily sedated. Abilify, Haldol, etc. etc.
Posted by Jeroen on December 11, 2004, at 15:44:25
In reply to Re: IM AFFRAID TO TRY CLOZARIL!!!, posted by TomG on December 11, 2004, at 15:36:21
i dont know what to do... im thinking of death, but that might not be a good solution,, if nothing can be done for my eyes, i cant have a normal life with this
Posted by ed_uk on December 11, 2004, at 15:54:09
In reply to Re: IM AFFRAID TO TRY CLOZARIL!!!, posted by Jeroen on December 11, 2004, at 15:44:25
Hi Jeroen,
I already suggested some treatments that could get rid of your blinking but you never replied. Did you read my posts?
Ed.
Posted by yxibow on December 11, 2004, at 16:15:33
In reply to Re: IM AFFRAID TO TRY CLOZARIL!!!, posted by Jeroen on December 11, 2004, at 15:44:25
A number of people have made suggestions about the blinking, including myself in the previous forum period that it _will_ get better over time, and focusing on it will make it worse for you. It's not facetious or sarcastic to say that focusing on body ailments or disfigurations serves oneself no self-good. Biological feedback is a real phenomenon and you can think yourself into a number of situations if one tries hard enough.
This all being said... it does seem to me that you have posted taking or wanting to take half the medications in the PDR. I am not sure where you live, or how you obtain these medications, but if you are combining them, it is disastrous.
Clozaril is the medication of last resort... it is manufactured generic by one company in the us, Novartis, and requires constant blood draw to watch for agranulocytosis, which occurs around 2%. This entire cycle costs $9,000 a year. So I'm not clear where you are obtaining Clozaril, unless you finally do have a doctor who is sorting this all out. In this case he or she would have discussed that risk, plus the fact that it can cause urinary incontinence. The risk of TD is zero though. And yes, it can reverse some TD sometimes. But its like taking a sledgehammer.
So My 2c... life is worth living for the sake of it... you've obviously lived through now with the blinking. We all sympathize with it, it is uncomfortable. But things like that more than likely improve over time.
Holiday tidings and sincerity.
Posted by linkadge on December 11, 2004, at 16:18:56
In reply to Re: IM AFFRAID TO TRY CLOZARIL!!! » Jeroen, posted by ed_uk on December 11, 2004, at 15:54:09
If you are thinking of suicide then I would definately stick to your clozaril idea.
Clozaril has a documented antidepressant and antisuicide effect. The only reason it is "last ditch" is becase of the possibility of drop in white cell count. The blood tests will detect this rare side effect if it does happen.
I was on zyprexa for a long time, and the sedation did wear off. You build a tollerance to antihistamine effects.
Linkadge
Posted by Jeroen on December 11, 2004, at 17:08:44
In reply to Re: IM AFFRAID TO TRY CLOZARIL!!! » Jeroen, posted by ed_uk on December 11, 2004, at 15:54:09
> Hi Jeroen,
>
> I already suggested some treatments that could get rid of your blinking but you never replied. Did you read my posts?
>
> Ed.hi im getting strange diagnosis, they say my eye is moving also while i blink, my psychiatrist said nothing can be done about it and that it aint blehrospams,, but i do feel like my eye always want to close
i read your treatment options, yes 1. Clozaril 2. BOTOX (my doctor said it woudnt help me 3. NEURONTIN (i dont know the dosage)
also im getting recommendations of vitamin E 1600 mg and B6 i already have ordered B6
i want to try ZYPREXA 30 MG, and AMANTADINE 300 MG next month to eliminated this neurological eye disease, its scares the hell out of me
I PRAY TO GOD SOMETHIMES for his help...
i already tryed ZYPREXA 10 MG for 3 weeks and the blinking was little bit better but my eye still feels weird... i quit it
dear god, its my 21 birthday thanks for the extra problem!
i take anti psychotics because i have paranoia but i dont hear voices, i never had that
the problems started when i was 14 years old, what disease could this be?
Posted by TomG on December 11, 2004, at 17:34:01
In reply to TO ED UK, posted by Jeroen on December 11, 2004, at 17:08:44
I have paranoia and delusions without hearing voices, and I have been diagnosed with schizophrenia. Voices do not have to be present when a diagnosis of schizophrenia is made. Are you seeing a psychiatrist and where are you located? And.....
linkadge I am curious to see where you have read or heard where antihistamine effects build up a tolerance. I have been on low dose Geodon 20mg for over 6 months and have had no let up whatsoever in sedation.
Posted by ed_uk on December 11, 2004, at 17:35:36
In reply to TO ED UK, posted by Jeroen on December 11, 2004, at 17:08:44
Hello Jeroen,
I'm glad you replied!
I think you really need a neurologist to diagnose your eye condition. Your psychiatrist probably won't have much experience in diagnosing neurological problems.
The problem with Zyprexa is that it can cause tardive dyskinesia. I think that it would be a good idea to ask your psychiatrist about Clozaril. I know that you are worried that Clozaril might cause too much drowsiness but if you started with a very low dose and increased gradually you might not have a problem. The drowsiness caused by Clozaril usually decreases after you have been taking it for a while.
Best Wishes,
Ed.
Posted by ed_uk on December 11, 2004, at 17:37:43
In reply to Re: Jeroen, posted by ed_uk on December 11, 2004, at 17:35:36
Jeroen, what does your psychiatrist think is wrong with your eye?
Posted by Jeroen on December 11, 2004, at 17:37:50
In reply to Re: IM AFFRAID TO TRY CLOZARIL!!! » Jeroen, posted by TomG on December 11, 2004, at 17:34:01
dont talk about the freaking geodon... OH PLEASE,, the first 2 days i felt REALLY GOOD but then the nightmare for me started and isnt over yet
i felt something is wrong about that drug...
Posted by Jeroen on December 11, 2004, at 17:41:14
In reply to Re: Jeroen, posted by ed_uk on December 11, 2004, at 17:37:43
a muscle from my eye causing these abnormal movements, he sais its very rare but it appears to exist, my neurologists sais it will go away but its been 3 months now.. my psychiatric doctor sais nothing can be done on it, and that it aint bleherospasm
another doctor sais it can only be that blaherospams so im getting nuts
Posted by ed_uk on December 11, 2004, at 17:43:33
In reply to TO ED UK, posted by Jeroen on December 11, 2004, at 17:08:44
Hello! :-)
Geodon has very little antihistamine effect. It causes sedation via a different mechanism.
Are you well at the moment?
Regards,
Ed.PS. I think we need more people with schizophrenia on psycho-babble because we have lots of people with mood and anxiety disorders but not many with schizophrenia.
Posted by ed_uk on December 11, 2004, at 17:46:14
In reply to Re: Jeroen, posted by Jeroen on December 11, 2004, at 17:41:14
Hello Jeroen,
I think you need to make another appointment with the neurologist. Will you make another appointmant?
Best Wishes,
Ed.
Posted by Jeroen on December 11, 2004, at 17:55:49
In reply to Re: Jeroen » Jeroen, posted by ed_uk on December 11, 2004, at 17:46:14
yes,, can Zeldox gave me eye damage? i experience light sensivity, i didnt had this before
Posted by TomG on December 11, 2004, at 17:58:54
In reply to Re: To Tom, posted by ed_uk on December 11, 2004, at 17:43:33
Ed,
Geodon does in fact cause sedation through the H1 histamine receptor. If you go to the online product insert at http://www.pfizer.com/download/uspi_geodon.pdf you will see that the somnolence observed with Geodon is thought to be from antagonism of H1 histamine receptor. Also check out this article which goes more in depth about sedation and AP's. http://www.psychiatrist.com/pcc/pccpdf/v06s02/v06s0201.pdf
But you may be right the sedation I'm experiencing might be via another mechanism but no research I've read points any other direction. But, I have to try something else. I'm OK on Geodon though. Its great for deep depression, anxiety, cognition, confusion, paranoia. The sedation I'm having is mimicking some negative symptoms of schizophrenia like anhedonia, amotivation, avolition. I know these symptoms are caused by the sedation and not a reemergence of symptoms from the disease itself. I'm about to seek out another AP, so if nothing else works I'll always have Geodon to fall back on. It has been a miracle drug for many of my main symptoms.
Posted by ed_uk on December 11, 2004, at 19:25:34
In reply to Re: To Tom » ed_uk, posted by TomG on December 11, 2004, at 17:58:54
Tom,
Although it is a possibility, I still think that it is unlikely that your sedation is caused by H1 antagonism. You are on a low dose of Geodon and it is a weak antihistamine. Pfizer does not say that sedation is always caused by H1 antagonism, they just suggest that it might be in some cases. Your sedation could be due 5-HT2a antagonism.
Regards,
Ed.
Posted by ed_uk on December 11, 2004, at 19:31:07
In reply to Re: To Tom » ed_uk, posted by TomG on December 11, 2004, at 17:58:54
It sounds like you've really benefited from Geodon. Are you thinking of trying Abilify?
Ed.
Posted by TomG on December 11, 2004, at 21:07:20
In reply to Re: To Tom, posted by ed_uk on December 11, 2004, at 19:31:07
Well Ed, my doctor always asks me when we start talking about this sort of thing, "Why does it matter?". I agree with him that trying to guess what mechanism the sedation is caused by is sort of useless. I do know that my sedation didn't start until about two months into taking Geodon. I experienced *no* sedation during the first two months except a little each night after I would take it. I also tried Provigil and it had absolutely no effect on the sleepiness whatsoever. So, you may be right the sedation may be caused by 5ht2a antagonism, but theres not a whole lot I can do about that. I may be benefitting from the 5ht2a antagonism that Geodon provides. Most of the newer atypicals provide 5ht2a antagonism and some of the older ones do as well. At this point I know I need an antipsychotic and the only thing there is left to do is to try them all. Hopefully I can find one just as good as Geodon without the sedation.
Posted by ed_uk on December 12, 2004, at 2:18:11
In reply to Re: To Tom » ed_uk, posted by TomG on December 11, 2004, at 21:07:20
Hello Tom,
I'm not sure where you live but here in England (where we don't have Geodon) we have amisulpride (Solian) which is not usually very sedating.
Regards,
Ed.
Posted by TomG on December 12, 2004, at 10:33:54
In reply to Re: To Tom, posted by ed_uk on December 12, 2004, at 2:18:11
Ed, Yes I am very interested in Amisulpride (Solian). I talked to my doctor about it, but he said he'd never heard of it. That seems right, because I don't think many American doctors dabble in European drugs. However, I may discuss this further with him if all else fails. Amisulpride is a very specific drug in that it only hits D2 and D3 dopamine receptors. I have no idea where I would order it from. Do you? It is nice to have it as an option if the other AP's don't work out.
Posted by Sebastian on December 12, 2004, at 10:34:47
In reply to Re: IM AFFRAID TO TRY CLOZARIL!!!, posted by Jeroen on December 11, 2004, at 15:28:14
You might want to take a AD! You can still take a AP with it in addition.
Posted by ed_uk on December 12, 2004, at 10:52:54
In reply to Re: To Tom » ed_uk, posted by TomG on December 12, 2004, at 10:33:54
Hi Tom,
Unfortunately, I don't know where you could get Solian. I imagine that you'd probably be able to get hold of it if you tried though!
I don't know why Solian isn't available in America. It seems strange because the FDA and the MHRA (UK) seem to agree on most things.
Have you tried any other APs apart form Geodon?
The late-onset drowsiness which you described reminds me of how I get late-onset sedation with SSRIs. After all, Geodon is a weak serotonin reuptake inhibitor so perhaps it might have a similar effect.
Regards,
Ed.
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