Treatment resistant SZ

Here is the link to the article.

I think clozapine has become more common than it used to be.

I have treatment resistant sz. Clozapine killed my white cells.

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Clozapine was quickly killing me. Yay clozapine! But no one cares about me anyway.

i didnt like clozapine also… it made me more paranoid, more panicked, i stopped eating and was akathisic(strange for this med). i tried to readjust the dosage but it wasnt ok. i think the meds are not the only solution. now i am on zyprexa, i prefer it to clozapine but its not a miracle, i suffer a lot still but i am special :/…

I’ve been on clozapine since 2 years. It works great for my positive symptoms. But I’ve to take a certain dose, if I increase my dose from that point, my white blood cells keeps dropping. I’m lucky to be able to find a dose where my white blood cells are stable and are not dropping below normal levels.

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A lot of sz pts are too biogenetically > physiologically sensitive for Clozaril and will do better on the less pharmacologically “complete” anti-Ps that don’t pave over every single Da2 and Da4 receptor in their limbic systems. But for those who are more severely afflicted, Cloz is very often the “magic bullet.”

If one can get by on 'Quel quetiapine or 'Fy arapiprasole or Invega paliperidone or Latuda lurasidone, fantastic. If not, what the APA is saying is that statistically the odds of getting emotional and other symptom relief for the pt are better by skipping the alternatives and going straight to Cloz without other relatively less “invasive” experimentation (e.g.: Risperdal risperisone, Geodon ziprasidone, Zyprexa olazepine), at least for a while.

What we’re seeing out in the trenches is that the long-acting, atypical injectables (see below) are “statistically superior” at reducing symptoms and providing a better quality of life for many sz pts, thus reducing the need for many to switch to Cloz. See http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4212490/.

Prolixin fluphenazine-LAI (typical)
Haldol haloperidol-LAI (typical)
Abilify aripiprazole-LAI (atypical)
Zyprexa olanzapine-LAI (atypical)
Invega paliperidone-LAI (atypical)
Risperdal risperidone-LAI (atypical)

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I had very bad experience with clozapine. It almost killed me. I have never miss the blood test but ■■■■ things stil happened. I have been put on the hospital on June. I was vomitted many times during the day. It’s really suffer. My gall bladder had been removed. I still feel the pain on the surgical wound now…

sorry for you 151515

I tried clozapine and it nearly killed me - I was suicidal anyway - why do you think they went to Latuda and not an injectable?

Probably (how can I be sure at this distance?) because Cloz hit too many D2 and D4 receptors for you to be able to tolerate it. (Like I said, Cloz does a very “complete” job.) Latuda does a far less “complete” and (for some) more appropriately “targeted” job. You can dig into Stephen Stahl’s published work if you’re way into all this.

If it wouldn’t have killed me do you think I would have felt better on Clozapine?

As it is now each day is full of pain.

Not if the side effects were extreme. The use of dopamine-suppressing anti-Ps is most often a matter of treating the symptoms with a minimum of side effects. Many patients go through five, six, eight different meds before they find one or tow that work well for them. THEN it’s a matter of doing the psychotherapies that knock down the nurture side of the “nature and nurture” equation.

They decided to keep me on Latuda. Each day is a marathon of pain.

Are you saying physical or emotional pain?

Both 515151515151515151515151

For an anti-P, Latuda is a fairly “drastic” change from Cloz (with it’s relatively high propensity for sfx), so let’s see what happens over the next week or two. Keeping my fingers crossed for you.

Thank you notmoses - so far so good