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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by pretty_paints on January 13, 2005, at 11:41:36
Any opinions guys?
Are they equally prescribed or is Clozapine used in less cases?
Pls let me know your thoughts on either!!
Thanks
Posted by ed_uk on January 13, 2005, at 11:54:38
In reply to ABILIFY or CLOZAPINE (which is better?), posted by pretty_paints on January 13, 2005, at 11:41:36
Hi!
Clozapine (Clozaril) is mainly used for severe treatment-resistant schizophrenia. It is usually very sedating. Regular blood tests are needed. Clozapine has well-established efficacy in schizophrenia resistant to other drugs.
Aripiprazole (Abilify) is a much newer drug. It is less sedating and doesn't cause as much weight gain as clozapine. It effectiveness in severe treatment-resistant schizophrenia is not established.
Ed xxx
Posted by pretty_paints on January 13, 2005, at 11:59:50
In reply to Re: ABILIFY or CLOZAPINE (which is better?) » pretty_paints, posted by ed_uk on January 13, 2005, at 11:54:38
Hi Ed,
I have put on about 2 stone through taking Zyprexa (put the majority of weight on) and Seroquel (maintained this weight). I absolutely LOVE the fact that I have gone from a pathetic 7.5 stone to a lovely normal 9.5 stone. I have hips and a bum and am much more curvy!!
AM I GOING TO TURN BACK INTO A SKINNY LITTLE RAKE ON ABILIFY??!!
Please nooooooooooooo
:o(
Posted by ed_uk on January 13, 2005, at 12:09:32
In reply to Re: ABILIFY or CLOZAPINE (which is better?), posted by pretty_paints on January 13, 2005, at 11:59:50
Hello!
It's usually easier to gain weight than to loose it! Abilify sometimes causes weight gain but apparantly not as much as Zyprexa. Anyway, you're on Zispin- the queen of curves, so you might not loose a pound!
Why did you quit Zyprexa?
Ed xx
Posted by pretty_paints on January 13, 2005, at 12:19:16
In reply to Re: ABILIFY or CLOZAPINE (which is better?) » pretty_paints, posted by ed_uk on January 13, 2005, at 12:09:32
Zyprexa was used in hospital to get things back into perspective, and actually looking back on it, it was very good. It stopped the feeling like I was constantly being watched, it stopped the feelings like people were talking about me etc. It actually stopped much more of the so say "psychotic" symptoms than the Seroquel did. But for some reason, the Seroquel actually made me feel BETTER, even though quite a lot of psychotic symptoms remained. I just felt less depressed, more positive, generally clearer, and I just felt that I was a GOOD person, that I didn't need to feel bad, that people didn't hate me, etc etc.
So at the time I guess I came off the Zyprexa because it was a case of "yes it's working, but could something else work better?". I wasn't particularly happy, still very down, and just wanted to see if something else might be better.
Seroquel, as I said, left me with more symptoms hanging around (which is why now I'm changing again), but it has made me feel good and able to laugh.
It's all very complicated isn't it. Makes my brain go funny :os
Posted by ed_uk on January 13, 2005, at 12:24:44
In reply to Re: ABILIFY or CLOZAPINE (which is better?), posted by pretty_paints on January 13, 2005, at 12:19:16
Well, try the Abilify and see how it goes :-) Some people end up on low doses of two antipsychotics combined to try to get the benefits of both!
Ed xx
Posted by ed_uk on January 13, 2005, at 12:25:37
In reply to Re: ABILIFY or CLOZAPINE (which is better?), posted by pretty_paints on January 13, 2005, at 12:19:16
PS. Perhaps the dose of Zyprexa was too high. What doses did you try?
Ed.
Posted by pretty_paints on January 13, 2005, at 12:42:45
In reply to Re: ABILIFY or CLOZAPINE (which is better?), posted by ed_uk on January 13, 2005, at 12:25:37
I went from 5mg up to 20mg (in stages obviously). What would a high dose of an antipsychotic cause?
Posted by ed_uk on January 13, 2005, at 12:54:00
In reply to Re: ABILIFY or CLOZAPINE (which is better?), posted by pretty_paints on January 13, 2005, at 12:42:45
Hi!
High doses of antipsychotics sometimes cause dysphoria (mental distress). I wondered whether the reason that you felt bad on Zyprexa might have been too high a dose. 20 mg is quite a high dose, which might also explain why Zyprexa was more effective in controlling your psychotic symptoms. All I'm saying is, don't rule out trying Zyprexa again in the future at a lower dose.
Are you ok? You don't 'sound' happy anymore? Have I upset you?
Ed.
Posted by pretty_paints on January 13, 2005, at 14:01:58
In reply to Re: ABILIFY or CLOZAPINE (which is better?), posted by ed_uk on January 13, 2005, at 12:54:00
Hi Ed,
No of course you haven't!
I was wondering if you could explain something for me? As I said about in my other post, no-one really knows what my diagnosis is: psychotic depression or schizophrenia-type disorder. But that doesn't really matter so much.
The point is, the pdoc says that Clozapine is only prescribed for treatment-resistant schizophrenia, and since she doesn't know what I have yet, she's prescribing Abilify instead. I asked her why she couldn't prescribe it just for "general psychosis" like she prescribes the other AP's, but she didn't really see what I was saying. Do you have any ideas about this? Is Clozapine the only AP which is prescribed for a specific condition, instead of just general symptoms? Why, for example, can't the pdoc just refuse to give me the Abilify because I haven't been diagnosed with schizophrenia?
Thanks a lot for any advice!
Posted by ed_uk on January 13, 2005, at 15:45:22
In reply to Re: ABILIFY or CLOZAPINE (which is better?), posted by pretty_paints on January 13, 2005, at 14:01:58
Hi Katie!!!
> Is Clozapine the only AP which is prescribed for a specific condition, instead of just general symptoms?
In the UK, clozapine *can* be prescribed for all forms of psychosis, not just schizophrenia. I don't know whether that is true in other countries. Because of its sometimes serious side effects, however, it is usually reserved for the treatment of severe resistant schizophrenia. Clozapine is occasionally prescribed for mania, psychotic depression and even borderline personality disorder.
>Why, for example, can't the pdoc just refuse to give me the Abilify because I haven't been diagnosed with schizophrenia?
Well, she could refuse if whe wanted to!
In the UK, once a medicine has received a marketing authorisation (a license) it can then be prescribed 'off-label' for any condition that the doctor feels might be helped eg. In the UK, Zispin is only approved for the treatment of depression, yet a doctor is permitted to prescribe it for any reason that they deem to be appropriate, such as anxiety. Some doctors don't like prescribing drugs 'off-label' because it increases the chance that they might be successfully sued if the patient suffered serious side effects!
Ed xx
Posted by pretty_paints on January 14, 2005, at 13:44:10
In reply to Re: ABILIFY or CLOZAPINE (which is better?) » pretty_paints, posted by ed_uk on January 13, 2005, at 15:45:22
Hi Ed,
Thanks for the info!!
Kate xx
This is the end of the thread.
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