Looking for your experiences with AP's (long)

Yes, they are related. The -pine drugs, strange as it may sound, all contain a benzodiazepine structure (or a derivative of the benzodiazepine structure). That's where the "-pine" comes from. They don't act like benzodiazepines in the sense that they aren't addictive, but they are chemically similar. Zyprexa (olanzapine) is a thienobenzodiazepine, Seroquel (quetiapine) is a dibenzothiazepine, and Clozaril is a dibenzodiazepine. They tend to be more sedating and cause more weight gain than the other atypicals in the population as a whole, though personally my experience was that they caused the least weight gain and Abilify caused the most, so I think in some sense you have to take the side effects with a grain of salt because they're so variable from person to person. Anyway, this is off topic, but hopefully it answers your question

Thanks Hope for Change. That was interesting since the only APs that ever have worked for me were Seroquel and clozapine. I didn't know they were related.

Yes I believe all the atypical AP’s are ‘pines’.
What works for one person may not work for another. And side effects are different for each person.
Have you ever tried Lithium? It’s used as both a mood stabiliser and functions as a AP for some people.

That's what confused me; all the atypicals aren't -pines. Rexulti is brexpiprazole, geodon is ziprasidone, abilify is Aripiprazole, riserdal is RISPERIDONE, invega is paliperidone....so -dones and -zoles maybe too? I'll have to ask my pdoc out of curiousity.

Oops. Yes you’re 100 percent right. Now I’m curious: what is it that makes an atypical AP atypical?

And to make it weirder, azoles can also be anti-fungals. So that can't have any meaning.

So to my understanding, the -dones are all of the benzisoxazole structure, which is different from the benzodiazepine structure of the -pines. Aripiprazole is derived from a molecule with an azole group, among other things. Antifungals are, too, but the rest of the drug molecule (the part in addition to the azole ring) is very different

The differentiation between typicals and atypicals is based partly on when they were developed (atypicals are 2nd and 3rd generation antipsychotics, so came later). It's also based on the fact that atypicals have serotonergic activity in addition to dopaminergic activity, and therefore are theoretically better for negative symptoms in patients with schizophrenia (e.g. poor motivation, poor hygiene, lack of emotions, etc.). Personally I think typical vs. atypical aren't as separate of categories as they're made out to be, but that's just me, so take it with a grain of salt

Oh--to further confuse things, technically risperidone, iloperidone, and paliperidone are benzisoxazoles, while lurasidone and ziprasidone are benzisothiazoles. I think the distinction between the two structures isn't super significant, though

All of that said, I've had tremendous luck with the 1st generation, or typical, antipsychotic perphenazine. It's controlled my psychosis and mood symptoms with very few side effects. Of course, everyone is different, but I am surprised to hear of a blanket policy of not prescribing 1st generation drugs. They don't have sophisticated marketing, but in my opinion they are just as good.

I agree with you. Many claim the first generation has a higher risk of TD. I have bradykinesia and other neuromuscular issues with the atypicals.

I took perphenazine for years without any issue, too.

Thanks for sharing!

WC

—-hey, blue, could u say what industry u r in. Might give us some ideas for work at home.

Yeah you're right! It is about metabolism for sure, and everyone is different. I've been off the forum for a few days so I haven't caught up on the rest of the conversation yet. Lol yeah maybe the bears won't be as active. A winter activity that I've always wanted to try is snowshoeing! Maybe you could find something new to do that's active....or get an indoor stationary bike? Easier said than done. I have 2 exercise machines and I don't like doing them. I'd rather be outside!