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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by tensor on April 1, 2023, at 3:14:09
Brand names: Depixol and Fluanxol. First generation AP.
I have been struggling with anxiety my whole life and I have let it shrink my world to an unacceptable level. So I have resorted to stronger medications to hopefully get some relief.
I wrote in an earlier post that I tried chlorprothixene (Truxal). It's been over a month and I have evaluated it. My conclusions are that it can only be taken as PRN for emergency level symptoms only since it's too sedating. I tried taking it everyday at bedtime for two weeks, first 30mg and then 45mg. This works pretty good for anxiety, and the sedation is gone by the morning (or whatever time I get up). I suppose I can top up the dose daytime should a situation emerge where more anxiolytic effect is needed. However, I have been feeling a bit sluggish, I usually have more energy this time of the year and I haven't had the energy to do much the past weeks. Hard to say if it's due to Truxal, but I think it can make me sluggish daytime.
To complicate things, I have had a few really good days, with a bit of energy and reduced anxiety. Like, i have been travelling with a ferry, and 8hr trip to a nearby city and then back the next day. No problems, but this hasn't really been a problem before either, maybe I could relax a bit more this time thanks to Truxal. However, it's the longer trips and flying that have been impossible, and still are. And also, the everyday anxiety for no obvious reasons would be nice to suppress as much as possible.
So I decided I want to try a similar medication that is less sedating. My doctor rejected several propositions but agreed that flupentixol could be worth trying. I started yesterday with a small dose, 0.25mg, I have 0.5mg pills, but I cut one in half to see how I would react to it. Nothing dramatic, so I took the other half 2.5 hours later. Of course, ditching Truxal and starting a more activating (well, hopefully) medication didn't lead to much sleep last night, but I still feel more rested than usual. Took my second dose of 0.5mg this morning and I don't feel much yet, maybe a little more social. But nothing like Truxal which actually knocked me out the first time I tried it, 30mg and I fell asleep a few hours later, my wife had to wake me up for dinner.
If everything goes well I will continue evaluating this medication, if it can lift my mood then my anxiety is usually reduced as well. If I can't get enough anxiolytic effect from it, I will likely go back to Truxal, hoping that over time the sluggishness will disappear and that it can be a bit like an antideprassant as well, I believe my two week trial is too short to really know.
In two weeks I will meet another doc for a second opinion, it was my doctor who suggested it, she want another doctor to have a look at my situation and treatments.
What do you think about my plans? Any experiences with Fluanxol/Depixol?
/tensor
Posted by undopaminergic on April 1, 2023, at 12:09:02
In reply to Flupentixol, posted by tensor on April 1, 2023, at 3:14:09
> Brand names: Depixol and Fluanxol. First generation AP.
> I have been struggling with anxiety my whole life and I have let it shrink my world to an unacceptable level. So I have resorted to stronger medications to hopefully get some relief.
> I wrote in an earlier post that I tried chlorprothixene (Truxal). It's been over a month and I have evaluated it. My conclusions are that it can only be taken as PRN for emergency level symptoms only since it's too sedating. I tried taking it everyday at bedtime for two weeks, first 30mg and then 45mg. This works pretty good for anxiety, and the sedation is gone by the morning (or whatever time I get up). I suppose I can top up the dose daytime should a situation emerge where more anxiolytic effect is needed. However, I have been feeling a bit sluggish, I usually have more energy this time of the year and I haven't had the energy to do much the past weeks. Hard to say if it's due to Truxal, but I think it can make me sluggish daytime.
> To complicate things, I have had a few really good days, with a bit of energy and reduced anxiety. Like, i have been travelling with a ferry, and 8hr trip to a nearby city and then back the next day. No problems, but this hasn't really been a problem before either, maybe I could relax a bit more this time thanks to Truxal. However, it's the longer trips and flying that have been impossible, and still are. And also, the everyday anxiety for no obvious reasons would be nice to suppress as much as possible.
> So I decided I want to try a similar medication that is less sedating. My doctor rejected several propositions but agreed that flupentixol could be worth trying. I started yesterday with a small dose, 0.25mg, I have 0.5mg pills, but I cut one in half to see how I would react to it. Nothing dramatic, so I took the other half 2.5 hours later. Of course, ditching Truxal and starting a more activating (well, hopefully) medication didn't lead to much sleep last night, but I still feel more rested than usual. Took my second dose of 0.5mg this morning and I don't feel much yet, maybe a little more social. But nothing like Truxal which actually knocked me out the first time I tried it, 30mg and I fell asleep a few hours later, my wife had to wake me up for dinner.
> If everything goes well I will continue evaluating this medication, if it can lift my mood then my anxiety is usually reduced as well. If I can't get enough anxiolytic effect from it, I will likely go back to Truxal, hoping that over time the sluggishness will disappear and that it can be a bit like an antideprassant as well, I believe my two week trial is too short to really know.
> In two weeks I will meet another doc for a second opinion, it was my doctor who suggested it, she want another doctor to have a look at my situation and treatments.
> What do you think about my plans? Any experiences with Fluanxol/Depixol?
> /tensorI was given Truxal as a PRN option for insomnia, after I expressed concerns that levomepromazine (Nozinan) would make me tired in the morning. I guess it has a shorter duration of action. I never got around to trying it.
I have used flupenthixol (Fluanxol) a lot. I tried it as an antidepressant starting at 0.5 mg. Later, they insisted that I needed neuroleptics, and Fluanxol was one of my suggestions. Alas, I did not notice an antidepressant effect, but it also didn't seem to yield the sedation that is so common with many antipsychotics. At several milligrams it produced inorgasmia, and some motor restlessness, but not akathisia.
-undopaminergic
Posted by tensor on April 1, 2023, at 12:23:23
In reply to Re: Flupentixol, posted by undopaminergic on April 1, 2023, at 12:09:02
> I was given Truxal as a PRN option for insomnia, after I expressed concerns that levomepromazine (Nozinan) would make me tired in the morning. I guess it has a shorter duration of action. I never got around to trying it.
>
> I have used flupenthixol (Fluanxol) a lot. I tried it as an antidepressant starting at 0.5 mg. Later, they insisted that I needed neuroleptics, and Fluanxol was one of my suggestions. Alas, I did not notice an antidepressant effect, but it also didn't seem to yield the sedation that is so common with many antipsychotics. At several milligrams it produced inorgasmia, and some motor restlessness, but not akathisia.
>
> -undopaminergic
Do you have a favorite among the FGAs? Do you suffer from anxiety disorders, if so, did Fluanxol help with that?
If I understood correctly flupentixol binds somewhat to 5HT2A and 5HT2C, but not as much as chlorprothixene. I wonder if some of the other medications I take can mitigate s/e such as EPS and akathisia (I have not yet experienced it from these two APs), like fluoxetine, mirtazpine and nortriptyline all have this property (5HT2A antagonist).
Could they make a typical AP more atypical? Is the risk for TD reduced?
45mg Truxal didn't effect my sexual ability, ie erection and orgasm. But it's a low dose.Thanks for your input.
/tensor
Posted by tensor on April 8, 2023, at 10:54:56
In reply to Flupentixol, posted by tensor on April 1, 2023, at 3:14:09
Back on Truxal, 45mg/d.
Fluanxol 0.5mg/day did nothing for three days and after that I could sleep at anytime, but no anxiolysis./tensor
This is the end of the thread.
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