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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
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
Posted by b2chica on October 25, 2013, at 16:37:41
In reply to a carousel of SGAs/atypicals?, posted by Snell on October 25, 2013, at 7:11:06
zyprexa has always seemed to work well for me. However due to weight gain i try to only take it as needed. which tend to be the winter months. it seems around november-ish through about march or so i tend to need augmenting.
But it seems to have always been my go-to drug. started in 2004, and off and on till -i was on it from Oct 2012-March 2013.Abilify, got extreme anger-increased dissociative episodes.
Seroquel gave me cognitive blunting.
Risperidal did nothing for me.
perphenazine was Great for my extreme anxiety
haloperidol didn't do much for my extreme anxietythere might have been another AAP (SGA) that i've been on but can't think of one for now.
but yes, zyprexa. it always seems to do the trick...and quickly (the brand anyway) generic do seem to take a bit longer to kick in.
b2c
Posted by doxogenic boy on October 26, 2013, at 10:05:29
In reply to a carousel of SGAs/atypicals?, posted by Snell on October 25, 2013, at 7:11:06
> 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?
I was forced to take risperidone in 1995 when I was committed to a mental hospital for medication-induced mixed state/agitated depression/mania (different diagnoses were proposed). It caused panic attacks and depression.
From December 2006, I have used Seroquel to augment antidepressants for treatment resistant depression/anxiety and insomnia. The extreme anxiety caused intense and very frequent suicidal thoughts.
Even though it was a partial response, Seroquel was the first drug that worked since June 2004; it was a life saver for me.(Escitalopram and trimipramine didn't work alone.) It still works, and with the other meds (see my signature) my depression was cured for about four years ago.
- doxogenic
Posted by Snell on October 28, 2013, at 16:50:07
In reply to Re: a carousel of SGAs/atypicals? » Snell, posted by doxogenic boy on October 26, 2013, at 10:05:29
> I was forced to take risperidone in 1995 when I was committed to a mental hospital for medication-induced mixed state/agitated depression/mania (different diagnoses were proposed). It caused panic attacks and depression.
>
> From December 2006, I have used Seroquel to augment antidepressants for treatment resistant depression/anxiety and insomnia. The extreme anxiety caused intense and very frequent suicidal thoughts.
>
> Even though it was a partial response, Seroquel was the first drug that worked since June 2004; it was a life saver for me.(Escitalopram and trimipramine didn't work alone.) It still works, and with the other meds (see my signature) my depression was cured for about four years ago.I'm sorry to hear about being forced to take risperidone. In 1995, that and Zyprexa were about all there were, no?
I'm thrilled, however, that you've gotten to remission. Congratulations.
>
> - doxogenic
Posted by doxogenic boy on October 29, 2013, at 17:16:55
In reply to Re: a carousel of SGAs/atypicals? » doxogenic boy, posted by Snell on October 28, 2013, at 16:50:07
> I'm sorry to hear about being forced to take risperidone.
They threatened me with haloperidol and amitriptyline injections, if I didn't take risperidone and paroxetine. It was a written decision, and I appealed, but it wasn't taken into account.
>In 1995, that and Zyprexa were about all there were, no?
No, Zyprexa wasn't available in Norway in 1995, only risperidone and clozapine of the atypical antipsychotics.
> I'm thrilled, however, that you've gotten to remission. Congratulations.
Yes, I hope the medication will continue to work this time. I will probably take these meds the rest of my life, if they still work, and if they (hopefully) still are available in the future.
- doxogenic
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