[Victoria'smom]

Are there any AP's you can use as needed? My husband wants me to have an PRN AP "just in case" but I can't find any that don't take weeks to kick in.

I think it depends on what you're seeking. For example, some people use Seroquel or Zyprexa as PRNs because those meds calm aggression and impulsivity very quickly, and that's due to the sedative properties of those meds. But Seroquel and Zyprexa, much like other APs, take quite a bit longer than a few hours actually kick in and handle symptoms. People are relying on the sedation and calming effects more than the actual anti-psychosis/anti-manic bit.

The other thing is... it's easier for a "PRN" to work faster if it's already built up in your system. For example, let's say you're taking... idk... risperdal everyday. Well, if you already have risperdal built up in your system because it's your regular med, then an increased dose will work faster compared to how risperdal would work if you had never taken it before. Or so this is what my pdoc tells me. That's why I think it's common for "as needed" APs to be the same AP you're already taking. So if you're taking abilify (I think?), then maybe 10mg is your normal dose and you have a 5mg PRN dose. That's usually what pdocs do, and it is recommended in the literature. I can find literature links if you're interested in learning more.

[Victoria'smom]

That makes sense. I've never had a "PRN" AP both Zyprexa and abilify work for me. I was thinking about using it for impulsive behavior.

Have you thought about a benzo as a PRN? Usually when we're impulsive, we're very revved up. Benzos are total chill pills. They knock down the energy/agitation a few levels and move you to a cooler spot.

[Victoria'smom]

I've only had one pdoc okay with giving me a benzo. I don't think I could bring myself to ask for one. I'm going to ask for an As needed medication for impulsive next month. I'm preparing to hear the word No but maybe. They don't tend to give me things like that. Benzo's work faster then AP's?

[all74]

Ask for clonazipam. My Pdoc told me that because of its half-life the other Pdocs he knows are more willing to prescribe it. It takes longer to kick in than, say, Xanax, though. But it works pretty well for me.

I have regular Seroquel (50 mg up to 150 mg) and Ativan (1 mg to 3 mg) to take as prns. They are both quite useful for me. I try to only take the Ativan for anxiety, or on occasion as a booster to help me sleep. I take the Seroquel when I feel manic symptoms develop. I'm talking early stage (hypomania). What I do is take from 50 mg to max 150 mg during the course of the day to calm manic symptoms. If that doesn't work after a couple attempts, I call my psychiatrist. Or, if I have to depend on higher doses of them every day for a few days, I call him. He then will increase my base medication, after which I can still take prns, if needed. I take 700 mg Seroquel XR as part of my base cocktail. The Seroquel for prn use is the iR kind.

One hospital psychiatrist said that I should keep Zyprexa in mind if ever I need extreme emergency mood control (i.e. at the hospital with severe mania w/psychosis). I took Zyprexa during that particular hospitalization and it worked amazingly well and fast. It was stopped only because I developed severe akathisia and rapidly gained weight after only a week on it. Another time, in the hospital, they gave me a Haldol emergency injection. That was a one-time deal only to control a delirious manic episode.

[Victoria'smom]

I don't think I'll need it but I'm going to ask for zyprexa disolvable just in case. My pdoc doesn't really do PRN so let's hope.