I have two possible options... Clozapine vs abilify

My doctor and nurse are gearing up for a med review, they don’t think chlorpromazine is effective for me anymore, is the impression I got, they may try an increase at my next appointments, and I will ask his advice. My nurse mentioned two meds; abilify (aripriprazole) which he seemed hesitant about , i have a tendency to become manic at times, and because the traditional atypically weren’t effective for me. The other one he said was a serious contender, was clozapine/clozaril. My heart sank, but I know it’s supposed to be very effective for people who don’t respond well to other meds, which is me. I know it’s Christmas Eve and I shouldn’t be worried, but I want to collect as much info and experiences of both meds, medication generic info, any side effects, whether it was effective, etc. I’m quite worried, mum seems to think a med change will do me good, but not until the summer, after my exam. She didn’t react badly to clozapine news. I’d appreciate any help.

Thank you, take care,
Meg.

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My friend is on Clozapine. AFAIK, it was the first 2nd generation antipsychotics.
He is prescribed with that med for the same reason as yours- not responding to other meds.
He needs to have regular blood test, FBC FBP,etc. And he was complaining about strong food appetite, and saliva at night.(not sure of the proper name of the side effect)

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Clozapine was the only med that ever worked for me, I would recommend trying it as it had much less side effects then other meds and you have less risk of developing tardive dyskenisia.

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I’ve heard the Clozapine is the “Gold Standard” in medicines. For those people that it works on - it works really well.

Its definitely worth a try.

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I’ve never tried Abilify, but I heard good about it. My pdoc suggested it to me, as I was struggling with sexual dysfunction side effects on my present pills (amisulpride). The only thing is it is expensive. As for Clozapine, I had a lot of side effects on it, especially sleepiness and drooling. It was the worst med I ever took, but I heard also a lot of positive things about it, so don’t be afraid to give it a try. The only thing is you will have to go for regular blood tests as a side effect is a change in white blood cell count.

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You mentioned an exam, so I take it you are a student? My experience with clozapine was that it turned me into a zombie, it made it very difficult to function and think cognitively. I don’t know if I had been going to school at the time if I could have done it. Just wanted you to know my take on it.

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Clozaril totally destroyed my balance. I could barely stand, and I was in serious danger of doing a nose dive into the carpet.

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I have 25 mg Abilify. It makes me calm. It made me feel again. I can feel joy, sadness, anger without being too much of it. I was on Zyprexa and Flupenthixol before Abilify and suffered from apathy and anhedonia.

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i’m on abilify and it hasn’t affected me adversely at all. the first time i tried it it was awful and i was bouncing off the walls with paranoia and agitation. too nervous to drive anywhere…this time i take it with 40mgs propanalol/inderal and it’s fine. i feel fine and i’m on 15mgs a day. it doesn’t seem to have done a whole lot for voices. mine come and go anyway and i think we’re just on a quiet period right now so i have to wait at least 6 months before i could say whether it has made a difference or not. definitely try it as some people it works wonders for in every respect. hope it works out for you xxx

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I hated abilify had the first reaction jaybebeal is tlking about couldn’t sit still couldn’t get any sleep couldnt relax horrible. clozapine if you have this you have to have a blood test every month I think.

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I did well on Clozaril. Several physical side effects. More sedating than the Zyprexa I take now.’

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Yes,I forgot about that one.

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Clozapine is very effective, used more often in Europe in fact, and it does have a potentially lethal side effect- it can alter (lower) white blood cell counts and compromise your immune system like AIDS, that is what I recall from my reading. They do regular blood tests if you take it. My doc said that if I go nuts again, he’s putting me on it.

Now do know that it is known for making people sleep too much (it is very sedating, you take it before bed and then you pass out, I would know because I’ve taken Zyprexa (olanzipine), it’s closest relative, olanzapine which was made after Clozapine in an effort to replicate the drug without the white blood cell thing. It is known to make people drool, I remember reading that.

However, it is known to treat anxiety and even alleviate negative symptoms to a degree. If you have problems with mania, it should be a good choice, as it is not exactly activating like Abilify or Latuda, which are known to help negative symptoms and not sedate people very much at all, however everyone is unique and that is just the average report.

I myself do not have mania, I just am very irritable, irate, enraged without Geodon and my other two auxiliary meds, xanax and propanolol, which are both sedating and have been found to decrease irritability and tremors, and Geodon gave me tremors. Geodon is somewhat sedating but it doesnt really knock me out at all, I take it morning and night and then can stay out at night and be alert. The xanax is what actually makes me sit still and not go practicing martial arts. However, I do delay my afternoon dose of it and go lift weights and immediately take the pill when I leave the gym, and it works quite well, I look quite strong and well I used to be a competitive lifter but that is a long story, I just workout to look big these days.

But yeah, for mania, it should do some good. I would steer clear of Abilify. That drug is just fishy, it’s a dopamine agonist, the opposite of all other antipsychotics, and it actually IS known to backfire and make people angry, crazy, manic, ect. sometimes. I refused it because I had read about it. It is used for major depression if that says anything about how fishy it is. My paranoid brain almost thinks that it’s a sugar pill. LOL

But clozapine and zyprexa do make people hungry, it screws with the satiation mechanisms in your body, I remember gaining a couple of pounds while taking zyprexa for like a month for an acute episode in addition to my other three meds. I would eat like a big weightlifter dinner and then not feel full. I had a hard time waking up. I slept like ten hours. It gave me sexual dysfunction, erectile dysfunction and it made sex pretty hard, I went limp twice while having sex but eventually it all came out ok…pun intended.

I love talking about meds. My first year, I was a neuroscience major.

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Both are damaging to the brain. Clozaril is very. Once you’re on it, it’s almost certain there’s no going back.

Abilify is the lesser evil.

I’d choose the third option - none.

This is not accurate information - as the examples from the people above demonstrate (for example, POB tried Clozaril and while it wasn’t ideal for her, she moved on to other medications and is doing ok).

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Without moving to another medication:

Try to go off Abilify
Then try to go off Clozapine.

You’ll understand what I mean. It’s almost impossible to go off meds if you’ve been on Clozapine.

I am on 5mg abilify can’t say it’s very good or very bad,it’s neutral,it causes sexual effect on me

I also take mirtazapine 30mg and it’s helping me,sometimes I think if I had depression with psychotic features or schizophrenia with mood issue,the latter seems to be my current diagnosis

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I was on clozapine. It had bad effects for me. I only stayed on it for 3 weeks.

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Clozapine has worked best for my son. Currently on Invega injection however considering going back to Clozapine. The problem is he doesn’t stay med-compliant so I worry about the negative side-affects of not taking it correctly or consistently. As far as I know it’s success rate is 40-60% which may be the best success rate for AP’s. Weight gain yes at higher doses. For my son 450 mg will cause some weight gain although I think exercise could have combated that. Drooling at night yes. Try limiting liquids before bed. Blood work - once a week for the first 6 months, then once every two weeks for 6 months then monthly. It is strictly monitored and pharmacies can’t dispense without seeing blood work results which is good as it does affect white blood cell count. If your WBC goes low then they should be able to catch it quickly. Having blood work done first thing in the morning can cause a lower result as you should be up and moving around for a bit to get the blood flowing. Not sure about eating before or not.

I think some experience higher balance issues. If my son stood up to quickly he would get dizzy however it still happens to him now, sometimes and he isn’t on Clozapine right now. I think most AP’s can cause this is some if sensitive.

It did help my son with anxiety.

It did sedate so he took it at night only however over time the sedating affect did get less.

To my knowledge Clozapine only affects or block dopamine. Abilify I think affects dopamine and serotonin and as mortimermouse said it’s a dopamine agonist which I think means helps the production of dopamine which can trigger psychosis for some while limiting serotonin. My son didn’t like Abilify.

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Clozapine is a sure choice. It will calm you down and wipe out all positive symptoms. For some, it is also good for negative symptoms. Abilify is somewhat opposite of clozapine. It’s not so effective but has less side effects. I take both. Very small dosage of Abilify and a bigger dosage of clozapine. Best regards

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