What other anti psychotic could I try?

Ballerina123 · 02-07-2013, 11:15 PM

I'm currently on olamzapine and I hate it; it's sedating, it makes me feel numb emotionally and I can't stop eating hence I'm gaining weight fast. I don't think I'll continue to take it when I leave hospital so I'd rather be on a medication I would be willing to continue with.

I have been on quietapine, aripiprizol and rispiridone and had to come off the because I had bad side effects (heart problems, prolatine issues and movement disorders). I can't go on amipsulpride because of the raised prolactain I got with the rispiridone.

Basically what are my options?

Aubergine · 02-07-2013, 11:23 PM

How long have you been taking the olanzapine? The sedation I felt with olanzapine did wear off with time. I gained weight initially, but I am losing it, though I won't pretend that it's easy. The numbness? I got that, but it completely wore off with me. I now feel the whole range of emotions.

I've been on haloperidol, risperidone and aripiprazole. Clozapine was going to be the next option if the olanzapine hadn't worked. That's supposed to be just as bad for sedation and weight gain though, so I'm not sure you'd be up for that. Also, it's quite a risky one for some people so you need regular blood tests.

Have you ever tried haloperidol? I had to come off of it because it was making me jerky, but it worked well while I was on it. It is an older, typical antipsychotic though, which means it has a higher side effect profile.

I know it's a nightmare finding the right med/combination of meds. *hug*

Cacoethes · 03-07-2013, 01:37 AM

Have you tried Clopixol?

Aubergine · 03-07-2013, 01:48 AM

I've heard good things about clopixol, both oral and depot injection. I've not tried it myself though.

FranticMind · 03-07-2013, 05:12 PM

im on depixol, it has virtually only a few side effects listed (even though i havent had any) and it isnt sedating at all, so that may help.

Ballerina123 · 03-07-2013, 06:31 PM

Thanks I'll ask my psych in my next ward round.

Abugeen- I've been on olanzapine 4weeks at 15mg.

Phells · 03-07-2013, 07:15 PM

I'm on Perphenazine right now, it's something you could try. My doctor said it was an old medication that was coming back into popularity. For women it has basically no side effects usually. The only downside is that you have to take it multiple times a day. I can't go on an effective dose because I'm under eighteen but you might have more luck with it.
Otherwise I was on Lurasidone (sp?) for a short period of time, but it made me nauseous.

Cedrus · 04-07-2013, 08:20 AM

Clozapine is an option. I've found it very helpful in comparison to other meds. I am guaranteed a good sleep every night which also helps my mood. I only get an increased appetite after taking the meds at night, througout the day I am fine. When I was on clozapine alone (450mg) I didn't feel too sedated during the day either, more a calm feeling. But another medication was introduced which has sedative properties which has destroyed my energy and erradicates the stimulating effect of coffee. I've been on clozapine for around 15 months.

I was on olanzapine and aripiprazole together for a year and didnt find sedation/appetite problems, towards the end of taking it i was loosing weight. maybe adding aripiprazole is an option?

nowhereman · 04-07-2013, 10:30 AM

I'm on geodon and serequel. They've both increased my appetite though. Otherwise they have been very helpful. Im on the serequel for derealisation though which you may not have, although the dr at the time thought it was psychosis. It's helped me control it but lately it's been coming back again.

Steel Maiden · 04-07-2013, 05:46 PM

I'm on olanzapine and amisulpride (two antipsychotics as I had a horrendous reaction to clozapine and two antipsychotics is the "next step up"). I don't get that sedated on them but I have put on weight on olanzapine.

The first-generation antipsychotics are an option but there is an increased rate of tardive dyskinesia on them. FGAs with increased antimuscarinic side-effects tend to cause less extra-pyramidal side-effects, but they have more weight gain/sedation.

I haven't got my BNF with me right now (so I can't check if these are marketed in the UK) but I remember that molindone is relatively weight-neutral. Zuclopenthixol (which I know is definitely marketed in the UK) is an option. I had that for a short while. Haloperidol is a bit less sedating / weight gain for most. But when I was on 20mg a day, although being effective, it made me feel very tired during the day (although I was taking it as split doses) and the akathisia / EPS were unpleasant.

As for the second-generation antipsychotics, most of them cause weight gain and sedation to some degree. Amisulpride doesn't cause as much sedation as, say, olanzapine, but it differs from person to person. However amisulpride can cause hyperprolactinaemia (my prolactin is three times the maximum normal limit). Aripiprazole is an option but you said you've been on that before.

I advise you to ask for a copy of the BNF and look up the side-effects of each antipsychotic. If that doesn't help, then the Electronic Medicines Compendium (Google it) is good and a trusted resource.