I take
clozapine 175mg
paroxetine cr 37.5mg
clobazam 10mg
escitalopram 10mg
10mg lexapro(escitalopram) at 8am is working so damn well for ocd but I’m so tired/sleepy that i wake up at 3-4pm on it.
I have tried all the different timings of taking the meds like divided dosing, all dose at bedtime etc - they don’t work. I believe bedtime dosing doesnt work cuz clozapine decreases serotonin and lexapro increases it, so they prolly cancel each other out ? Only 10mg at 8am works perfectly.
What should i do about tiredness and being sleepy ? Modafinil and coffee worsens my psychosis.
My next option would be to stop lexapro and add prozac - but it inhibits 2d6 and 3A4 - which would further increase clozapine and paroxetine blood levels. Increasing clozapine is bad - cuz it worsens ocd and anxiety and makes me less likely to tolerate any SSRI.