Switch to Amisulpride or Risperidone?

Medications
1

Been on clozapine since 5 years. Can’t bear the weight gain of clozapine anymore. I’m 100kg+ right now, and the weight wont come off. Stopping clozapine seem to be the only solution.

So, amisulpride seems to be very attractive option because it is less likely to cause weight gain and is very effective in reducing positive symptoms like clozapine. I was thinking about switching from clozapine to amisulpride but there are some problems with amisulpride and risperidone.

Amisulpride - I’m concerned about prolactin levels which is dose independent. That means reducing the dose of amisulpride wont help prolactin levels. 50mg and 500mg will have the same effect. Another problem is very high qtc prolongation compared to other antipsychotics caused by amisulpride which is dose dependent.

Risperidone also has prolactin issues but not like amisulpride, it has dose dependent prolactin elevation. Reducing risperidone dose will fix high prolactin or adding aripiprazole will also help. Another negative point is that risperidone will likely cause weight gain.

Any thoughts ? Should i switch to amisulpride or risperidone from clozapine ?

2

Risperidone was the first AP I was on and it was very effect in managing my symptoms. It brought me out of psychosis and got me sleeping.

However I did gain weight and likely would have continued to do so had I stayed on it. I didn’t like the way I felt on it so I changed medication but I’m back on something similar now anyway (paliperidone) and have those same feelings back lol

There are other anti psychotics also.

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3

I’m on amisulpride and I’m wanting to switch to clozapine

4

why do u want to change to clozapine ? Clozapine will make u fat

5

Most effective med there is and I can exercise plus I’m already pretty fat.

6

Amisulpride tastes foul every morning and everynight disgusting chalky taste in your mouth

7

Clozapine might be most effective for positive symptoms but I still have cognitive issues on clozapine.

8

I want the best chances I can get to be the best I can be.

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9

I have been on Amisulpride for about 6 months now. I really like it. i have lost weight and I am not made very tired.

I was offered Clozapine, but I had been on Olanzapine before and put on loads of weight, so I was put off it.

The prolactin thing doesn’t bother me. If it causes problems I will deal with it then.

My fall back drug of choice would be Haloperidol I think as I am totally against putting on more weight.

10

what dose of amisulpride u take ? have u developed enlarged breasts ?

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11

800mg no breasts

12

I was on clozapine some years back and had heavy side effects so I was switched to risperidone and went into remission for six years

After my relapse in 2012 I went back on risperidone but stopped it as I thought I didn’t need it and it was expensive.

Then when I went to hospital in 2013 they put me on amisulpride and been on it ever since. It’s an excellent med!

Both risperidone and amisulpride were good for me, both helped me into sanity.

13

I’ve been on paliperidone (invega) for 10 months and my weight has stayed the same. If I have gained a few kg it’s from eating junk food and not the meds. Paliperidone is the metabolite of risperidone. Very similar molecules. You should try it.

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