Hi spikes. It's impossible for me to know what would be the best and most tolerable for you. Based on your post above, you are offering Seroquel, Zyprexa, and Haldol as choices? I guess, being a fan of my Seroquel XR, and not having tried Haldol (other than a single emergency injection), I'd pick Seroquel, but not the regular kind. I'd pick the extended release. I have taken both the regular and extended release versions of Seroquel over the course of my bipolar treatment. I much prefer the extended release because my weight gain has been less on XR than it had been on the regular. In fact, I would go so far as to say that the XR version was even "weight neutral" for me up to about 500 mg. I was even able to make some progress with slow weight loss (or maintaining) at up to 600 mg. Lately, at 700 mg and 650 mg, I have had an increase in appetite. My Seroquel XR certainly could be a factor, but so could stress and the whole change in routine due to the covid 19 pandemic.

During the early stages of my Seroquel XR treatment, I did have some excess daytime sedation, but for some years now I haven't. I kind of like how the XR works vs. the regular. Very often, the tolerability of extended release forms are better than instant release. I even think the release action of the XR is partially why Seroquel XR is more weight neutral for me, than the instant release.

Seroquel XR is available as a generic, as of maybe two years ago? I have no problem with the generic. I took the name brand for a number of years, also fine. When I took name brand, I used a coupon to save money on my copay. There's still a coupon available from the Seroquel XR website.

I have gained some weight over the years, while on Seroquel XR, but I still regard it as mostly weight neutral. [Note: Not weight "friendly", but "neutral".] After all, a late 40s woman with a family of people who are overweight or even obese won't necessarily be waif thin. Over the past 8 years, I've gained about 20 lbs. That may sound bad, but I am only really 5 lbs more than I was at age 31 before I ever touched a bipolar medication in my life. I have surely been less physically active this past 8 years than I was at age 31. Perhaps if I was as active today as at age 31, I'd be even trimmer now.

I do believe my Seroquel XR contributes to my high cholesterol (especially), and to a lesser degree my high triglycerides. I don't watch my eating that much. Perhaps if I really cut down on the saturated fat, I'd see a positive difference. It is not the case that I am dieting and not seeing positive progress. I'm not dieting and I'm eating high fat high carb. In recent years, when I did eat lower carb, my triglycerides were normal. My glucose level has mostly been normal for the past 10 years, or only very slightly high. My blood pressure has mostly been normal, though it has increased this past year. Because of Seroquel XR? I'm thinking not. It's because of my lifestyle, and perhaps my age.

We're all different, though. Some may say they gained 150 lbs on Seroquel XR, but not me. In fact, other than the issues I mentioned above, I've had ZERO other side effects from Seroquel XR. I've read that (and my psychiatrist said) that in general, Seroquel tends to be less apt to cause EPS than other antipsychotics. It is also less apt to cause issues like hyperprolactenia. Obviously, there are the rare exceptions, but they seem rare.

Zyprexa was a major weight gainer for me AND it gave me akathisia. So I won't recommend that, though it did do a great job leveling my moods.

I like my current medication cocktail.