What are my antipsychotic options?

Medications
1

My clozapine has made my anxiety very severe that only benzo helps it but benzo has worsened my memory too. So I would like to reduce my clozapine to prolly 100mg from 175mg and add another antipsychotic to compensate and stop the benzo. I’m thinking about quetiapine but pdoc warns that it can mess with qtc interval on ECG report and worsen heart problems. My qtc is already above the normal levels.

Once I get to 100mg clozapine, I will add an SSRI to fix anxiety. Right now all antidepressants worsen my anxiety attacks.

Which antpsychotic should i add to clozapine ? Something effective and with least side effects

Here’s list of antipsychotics which failed:

Failed Meds: Amisulpride, Aripiprazole, Blonanserin, Olanzapine, Risperidone

2

How does an SSRI make anxiety worse?

Maybe the initial 2 weeks when your body’s adjusting to it, yeah.

3

Ever since i increased my clozapine from 100 to 200mg, my anxiety/panic has become worse. I’m not able to even tolerate antidepressants

My case is like this

Case reports suggest clozapine may be associated with or increase the incidence
of obsessive-compulsive disorder, panic, and agoraphobia. Treatment options for
comorbid anxiety and schizophrenia include a combination of psychopharmacology
and psychotherapy

https://pdfs.semanticscholar.org/2c84/f4256c6602634dbab1e23942307f0ac0883d.pdf

4

Why not go back on 100mg and add an SSRI?

Ask your pdoc, they know what’s best; but if your having bad anxiety, an SSRI is the way to go.

5

I wouldn’t add anything to clozapine it’s a pretty potent drug.

6

I can’t goto 100mg clozapine just like that. I had a relapse on 100mg so we increased the dose to 200mg to fix it. So if i reduce it further i might become paranoid. So i need to add another antipsychotic to compensate the low clozapine dose

7

Abilify doesn’t seem to cause anxiety

8

I’ve had anxiety on abilify. Hard to know if it’s the disease or the drugs mind you.

9

She already tried that. Aripiprazole…

10

Why not switching to invega from clozapine? Invega is quite effective

11

Invega might be effective, but it increases prolactin above the roof. Plus i dont want to take EPS meds along with it like artane or benztropine.

12

It doesn’t have to be high dose I’m on a medium dose and it’s alright.

13

What dose u take of invega ? Any side effects ? You got breast enlargement ?

14

Quetapine is Kinda calming and could work for you.
I cant take it though cause i got acid fluids.

15

Haloperidol works really well, but you would be lucky not to get EPS from it. I have seen some here on as little as 2mg as maintenance

16

Just found out invega should be taken with food or else absorption is reduced

17

I’m on 75 mg xeplion which is like 116 invega. Don’t have breast enlargement the side effect I have is low libido and that’s all. Managed to work for years on it and function well.