Might ask about Latuda, Vraylar, or Saphris

I was in the hospital for a little over two weeks in the month of January, due to an increase of auditory hallucinations, anxiety, and intrusive thoughts. A week before being admitted, my dose of Geodon was increased from 80 to 120 mg and Risperdal decreased from 2.5 mg to 2 mg. The reason for cross-tapering to Geodon was to avoid Risperdal’s side effect of brain fog, cognition, lack of concentration, and lack of motivation. The cross-tapering did help mildly to moderately with the cognition, although I was released from the hospital with Risperdal as my only AP.

My pdoc and I are still in the process of finding the AP with the best cognitive side effect profile, while still being effective in improving positive symptoms. She suggested Clozaril during my previous appointment, and my next one is on Wednesday. I am reluctant to take Clozaril, partly due to the fear and cringing at the thought of needles (due to mandatory frequent blood tests).

Due to the inconveniences and side effects of Clozaril, my mom advised me to consider an alternative AP, so I might ask my pdoc about Latuda, Vraylar, or Saphris, as these APs seem to be pro-cognitive.

How effective are these three, exactly, compared to Risperdal, in improving positive symptoms?

According to studies? Much less effective than Clozapine and less effective than risperidone. You will never know for sure until you try them.

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I’m on Lurasidone (Latuda) 60mg and it’s the best med I’ve tried. Zero positive symptoms and zero cognitive problems. My personal experience says try it, but everyone reacts differently to these meds so there is no telling how it will affect you.

I think I’ve been on it for about 3ish years now, however I recently developed Akathisia on it but that has been solved with Trazodone.

I had one pdoc that wanted to put me on clozapine too because it is stronger than olanzapine which I was on at the time, but I refused, got a new pdoc, and he suggested Lurasidone.

There are “trends” as to how effective they are but since everyone is different you don’t know until you try it it. I went from 40mg of Olanzapine which is a really high dose of a powerful AP to 60mg of Latuda, which is a much much lower dose, relatively speaking, of a weaker AP and yet I am doing way better.


I wish Latuda worked for me. My negative and cognitive symptoms were better on it, I was able to work in a low stress job while on it.

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Latuda is the only one I’ve tried. Worked ok on my mood symptoms, but did little if anything for my positives.

Zyprexa has worked well for me so far. Just have to monitor my weight. It’s helped cut the voices down, made them less powerful. I still get them, but life is much easier on the med.

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40mg of Olanzapine is insane! That change looks promising though.

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My brother used to take it. Made him gain weight rapidly.


It really is. I was on Olanzpaine for about 17 years. It took me about 4 years to slowly taper off it.

Did you get any akathisia on it?

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I did get bad akathisia on 80mg Latuda and still had positive symptoms. Dr upped it to 120mg but the akathisia was so extreme that I reduced my dose on my own back to 80mg. I had difficulty sleeping at night because of the akathisia. But everyone is different, maybe you won’t get akathisia. Lots of ppl get akathisia on Abilify but I never did, neither on Risperidone or Zyprexa.

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Latuda was great for me when it came to positives, but was a little sedating.
I had a lot of physical side effects.

Saphris is the best med I’ve been on, hands down. Weight going down instead of up, feeling more alive and alert, no side effects aside from a little sedation for the first few hours. But I take it at night, so I don’t mind that.
It seems to stabilise my mood and my impulse control too.


As far as intrusive thoughts are concerned Saphris took away ALL of my intrusive thoughts but it turned me into a zombie so I went off of it. But it might work for you @life. Can’t hurt to try it.

You need to listen to your psychiatrist and take Clozapine. There’s no reason to be afraid of needles.

I agree partly, but people can’t always control what they’re afraid of or how they react.
There’s always room for growth, and exposure is one way to get the growth started.

I never had a choice in the matter. I’ve been poked and pricked with needles since I was five, so I got used to them whether I wanted to be or not.

My sister almost never got exposed to needles. Despite having piercings and tattoos, she nearly faints when she has to have blood drawn. Every. Time.

A pdoc wanted to put me on clozapine but I refused. I’m not afraid of needles but that is the medication of last resort and that is still no guarantee. The constant blood tests are a royal pain in the ass not to mention some of the serious side effects it can cause.

I did the exact opposite of what you said, I got a new psychiatrist, he put me on Lurasidone (Latuda) and I lived happily ever after.

To hell with all this nonsense about stronger vs weaker antipsychotics. I was on a high dose of a strong antipsychotic (40mg of Olanzapine) and that is why the first pdoc wanted to put me on clozapine, because it is the strongest. But I ended up on Lurasidone which is a much weaker antipsychotic, I’m also on a much lower dose compared to the Olanzapine I was taking, and I am doing waaaaay better.

If I were him I’d try Latuda, Vraylar and Saphris and other meds before clozapine. In my experience pdocs are not always right. Even if statistically clozapine might work, everyone reacts differently to these meds so he should give the other ones a try first. Predictions are not possible. You have to try it and see what happens.


Clozapine works on a subset of people who don’t respond to other antipsychotics and it should be reserved for them.

Let me add that most antipsychotics weather 1. Or sec gen are equally efficient and only Clozapine and Solian (Amisulpride) worked bettet for the positives. But responses are individually. So you may find persons who have got a super response on a given antipsychotic. Eg headspark had a super response to Latuda. An antipsychotic that is ranked as the secon weakes antipsychotic for the positives.