The meds have failed, cbt not working really, so hwat can i do now?

karl · January 19, 2019, 3:29pm

im struggling hard with sz…i keep gatting meds changed, i may get a bit of relief but after a month im unwell again…cbt aint doing it either

what should i do…some of you schizophrneics must have advice

everhopeful · January 19, 2019, 3:34pm

Increase the dose of Olanzapine? I know you’re already at 20mg.

ncbi.nlm.nih.gov

Use of very-high-dose olanzapine in treatment-resistant schizophrenia.

JM Batail, B Langrée, G Robert, S Bleher, MC Verdier, E Bellissant, B Millet and D Drapier, Schizophrenia research, Nov 2014

Schizophrenia is a chronic illness with a progressive course that can be marked by resistance to antipsychotic treatment. This can make therapeutic support challenging for the practitioner, with results that are partial and unsatisfactory. In the literature, treatment with high-dose olanzapine (>20mg/day) appears to be a good alternative to clozapine, the gold standard for treatment-resistant schizophrenia. In the present observational prospective study, we studied the clinical and biological profiles of patients treated with olanzapine doses up to 100mg/day. In total, 50 patients were clinically and biologically assessed. We found a linear relationship between oral dose and serum concentration (Pearson's r=0.83, p<0.001) with effects of tobacco (p<0.05) and of coffee and tea consumption (p<0.01). Tolerance seemed to be good regardless of dose. No link was found between concentration and efficiency. Despite a nonexhaustive assessment of pharmacokinetic parameters, not least pharmacogenetic data (e.g., genotyping of cytochrome P450-1A2 or glycoprotein P Abcb1a), pharmacokinetic aspects alone cannot account for why the disease may sometimes be resistant to 20mg of olanzapine but respond to higher doses. A nuclear imaging study exploring brain occupancy by high-dose olanzapine, coupled with the abovementioned pharmacokinetic assessment, may prove a relevant experimental paradigm for studying the pathophysiological mechanisms of resistant schizophrenia.

karl · January 19, 2019, 3:44pm

thanks for your reply…yeah i used to be on 20mg olanzapine,but my pdoc changed it…im now on 800mg quetiapine and 9mg invega…butth the voices are driving me round the twist.

TheBest · January 19, 2019, 3:46pm

Man I’m sorry you are feeling bad @karl. I"m sure you have a lot of willpower. Just hang in there buddy.

everhopeful · January 19, 2019, 3:55pm

Maybe show that article to your doctor and say you’d like to try >20mg Olanzapine. That’s what Id do. I don’t know what else to suggest. I’m sorry you’re still suffering.

everhopeful · January 19, 2019, 3:56pm

From the article

pharmacokinetic aspects alone cannot account for why the disease may sometimes be resistant to 20mg of olanzapine but respond to higher doses.

anon98459728 · January 19, 2019, 4:13pm

Can you describe what your delusions are about?

FlyingPurplePeopleMeeter · January 19, 2019, 4:55pm

Have you tried Latuda?

ZmaGal · January 19, 2019, 5:00pm

I’m in the same boat. They keep changing my meds but nothing convinced me the men aren’t real. My therapist was all over me about logic and how illogical I’m being. It’s really frustrating. I’m now on Haldol. It helps me with some things but not everything.

By-my-design · January 22, 2019, 4:27am

Wat were u doing with CBT?

system · April 22, 2019, 4:27am

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