Anti psychotic options

[wombatsandaplant]

I’m looking into options of other antipsychotics.

Basically I’ve tried aripiprazole and quetiapine, both did nothing. I’m currently on haloperidol at 9mg and the psychiatrist said there’s no point upping it as it makes no difference. But the haloperidol is working less and less and I don’t think it ever worked properly. I’m barely functioning so need something better.

I don’t want to try olanzapine due to weight gain influence it has. Quetiapine made me gain 50kg so want something as near to weight neutral as possible.

I feel the only other options are paliperidone, lurasidone and risperidone. Clozapine was suggested last year before I went on haloperidol but I’m really against that. Though I’d be interested to know what people’s experiences of clozapine too.

Has any got any ideas of these?

What's your underlying diagnosis?

Psychosis

That's more of a symptom than a diagnosis. Have they told you anything else? Schizophrenia? Personality disorder? Psychotic depression?

Obviously you don't need to answer, but It's difficult to offer any suggestions without knowing why you're psychotic.

I’m not really sure they mentioned schizophrenia but never confirmed anything. They also mentioned delusional disorder too.

To be honest, it's quite trial and error. Any of those three options would do.

Risperidone is the most well known.

Clozapine is probably the most effective, but is something of a ball ache because of the monitoring. I would probably go for this option though if you feel very unwell and haven't responded to two others.

You can always switch once you're stable if the monitoring is too much

tbh I think it's really personal which antipsychotics work for you- I felt really ill (physically) on risperidone and haloperidol

I know clozapine is supposed to be the most effective for a lot of people but I also refuse to take it, the thought of the potential risks scares me too much

I've found amisulpride quite helpful and it has been weight neutral for me

Btw OP I really hope you find an effective med soon, psychosis is horrible, but I've been there and am now much better, there is hope

I moved over to 10mg haloperidol from 20mg olanzapine being honest while I gained a lot of weight on olanzapine it was honestly amazing.

But I will say the ten years stability olanzapine bought me was worth the weight gain even though I cannot even get it off after stopping and switching to Haloperidol.

You see I'm on 30mg Aripiprazole which is the top dose but I still get breakthrough symptoms of psychosis when I'm tired & stressed.
But I recognise the symptoms for what they are & as I'm on anti epileptics that go ok with the Aripiprazole I don't want to have change to a different anti psychotic.

I am on 4mg Risperidone and find it stops all my hallucinations. I went on Olanzapine briefly many years ago (15 years ago, my god) but it was the drooling and it making me feel like my brain had been 'wiped like an etch a sketch' is how I described it to my psychiatrist.

Medication can be a blessing and a positive but it is definitely a case of finding what works best for you in your situation and balancing out things like side effects, etc.

I have always been obese so that didn't really bother me as I would rather the other symptoms stopped.

I work in mental health so this is observation not personal experience - I have seen people do really well on clozapine. It can have an antidepressant effect, and doesn't lead to weight gain, and isn't sedating, all of which are great features in an antipsychotic. I know you need to be careful and have extra monitoring, but as an actual effective treatment I think it's got lots to commend it.

Thanks guys. Got to wait till Tuesday to see if the psychiatrist will listen to me.

I am on lurasidone and it's rather good but I would say the efficiency is like aripiprazole. I have tried and can't take these because of side effects: olanzapine, haloperidol, aripiprazole, amisulpride, quetapine and some other older ones. Surprisingly lurasidone doesn't give me any side effects.

I take clozapine,it works really well for me. The blood tests aren't that much of a hassle, titrating it can be annoying though.