Treatment resistant schizophrenia


I’ve taken almost all antipsychotics leaving Clozapine as possibly the only one. Most of the time I have paranoid thoughts, more of persecutory types and it’s making me a nervous wreck. I find it hard to leave my room without it, I perceive people as threats even if they wont harm me. Since Clozaril is the only med left, I’m afraid what if it doesn’t work out. Would ECT or TMS help?


I would try clozapine, and if it doesn’t work out you can try other options.


Clozapine is said by many to be the most effective antipsychotic, but of course it requires regular blood checks and it is not without risk.

I personally wouldn’t recommend ECT, as it can permanently affect your memory. For me, that would be devastating and not worth the risk. And I think that ECT is mostly effective for bipolar disorder and major depression.

I recommend Cognitive Behavioural Therapy (CBT), if it’s available.


I’m on clozapine and it’s the best med so far.

I dont understand why people put themselves through such torment by being sz resistant, and refusing to try clozapine…

What’s wrong with a weekly blood test.

Is chillllllllled


You can try medium dose clozapine as high dose causes many adverse effects. It has no EPS side effects nor does it increases prolactin. I take clozapine and it has totally destroyed my paranoia. But right now we r planning on reducing clozapine and adding risperidone instead. You should monitor ECG, Lipid profile, TLC/DLC, fasting sugar while you’re on clozapine.

No, I would not recommend ECT, it will destroy your cognition.


I’ve decided to not change my meds while at PHP. I will wait till I see my regular psychiatrist. I probably won’t do clozaril. Vraylar is really working for me and has been a miracle. I just started lions mane so wish me luck. I need to change my thoughts and behavior so no more conspiracy theories and I need to do healthy stuff. So far I feel 10x better.


For me, Clozapine wasn’t good. But a lot of ppl do well on it. I think @TheBest is on it. Correct me, if I’m wrong.


I’m glad you’re feeling better!


I’m on Clozapine, and it has been by far the best medication. My positive symptoms are almost completely under control, and it also helps a little bit with negative symptoms. It is worth while trying.


Er… I’m one of those people who is the reason for the blood test. Clozaril wiped out my immune system. Nearly died of pneumonia. All I can say is thank God for Geodon.


Only clozapine works for me in conjunction with lithium and lamotrigine. I’m down to bloodwork only once a month. That will be for as long as I take clozapine. The ladies who do my bloodwork are awesome.

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Clozapine worked well from me but I got bad sides. Wetting the bed every night, white blood cells were so low I had to go off it, and also increased my resting heart rate a lot (went from 50-90 resting bpm). Now that I am off it my heart rate is back down to around 65-70.

I am now on loxapine at a fairly low dose and it works as good as clozapine but no more sides. Loxapine at a higher dose gave me blurred vision and horrible side effects when I got a decent buzz from beer.

However, starting to get agitated by the voices I hear lately starting last week. Been on loxapine almost a year.

The other downside to clozapine at least where I am from is you have to be hospitalized at first due to them need to check your blood. They told me they needed a team to do this. But I am from a small city so maybe where you’re from you can get a team to work with you outside the hospital.

Good luck!


It has some downsides to it. One is that it takes a while to work 3-6 months for full effect. And a month and a half in, I was finally getting some benefit to it.

BUT I had some issues. Main thing is that my blood count was going on a downward trend. I don;t know if I was going to have to go off at it for that reason or if my blood would have eventually leveled out.

But what did put me off was sedation. Out of all the antipschs I’ve been on I’ve been able to overcome sedation. But not this one and I was at the point where if let me I would have slept more than be awake. And then thee was the drooling. Oh was that just hard. Pillow after pillow covered in drool.

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