Which antipsychotic?

I've been on Invega for over a year and I love it, but my psych nurse was getting me free samples.

I'm switching providers due to insurance, and I'm guessing my new psychiatrist won't be able to get me free samples.

Invega would cost $300 a month. I am not eligible for assistance programs because I have insurance. (that $300 price is AFTER insurance).

So....my options are:

Risperdal, in generic form, for a super-cheap $4 copay. But when we tried this at a low dose, I went manic within days. Should I try it but at a higher dose? We panicked and just went back on the Invega, didn't play with the dose. Possible weight gain too.

Seroquel, about $50 a month - but it would make me very sleepy, and probably gain weight. I've worked so hard to lose this weight....I don't want to gain it all back. I already have issues waking up for work on time, I oversleep.

Saphris - about $80 a month

Geodon - about $100 a month

These are guesses at the prices because I don't know what dose I would need.

All other options are either non-formulary on my insurance (and thus expensive) or drugs I've already tried and will NOT take again (Zyprexa made me gain 80+ pounds.....Abilify made me highly suicidal).

My appointment is Friday (tomorrow) at 8:00 AM with the new psychiatrist.

I will let him be the professional and make the ultimate decision - but what would you choose, out of these options?

I take risperidone - 4mg a day. I didn't gain any weight from it, and I've had minimal side effects. But the side effects I do get are freaky - it's messed up my menstrual cycle and I have some problem with minor lactation. I don't find it overly sedating.

If you're looking for something as a mood stabilizer, why not think outside the anti psychotic family and maybe consider lithium. I know it's old and requires frequent blood tests until you get the right level, but it does work.

Personally I'd avoid Seroquel like the plague. I know people who are on it, and they're basically zombies after taking it, and it's heavily sedating.

Remember though I'm not a pdoc. I just know a little bit about meds and know a bunch of people who are on different meds so I know a little bit about them based on their experience.

Good luck with the pdoc.

--splitimage

mmmmmm.......brains.........*walks around like zombie*

Currently I take 300 mg of Seroquel. 200 mg @ 8 pm, 50 mg @ 8 am, 50 mg @1:00 pm. I'm not that much of a zombie, but then again I take 20 mg of adderall xr @ 8:00 and 11:00.

reperidone was the first anti-psychotic I was ever on. I slept a good 15 hrs a day for a week, and decided that wouldn't work out.

Saphris is newer and since they passed a law (not sure if it's state or national) that psych offices where no longer able to accept freebies from drug companies, meaning that the psychiatric medicine peddlers stopped going to the offices every week, giving them more free samples. My doc has to 'order' them from the drug company so they can be sent there. Many drugs aren't even giving out samples, they're going to the 'savings card' option instead. Anyways, all of that was supposed to mean that with out samples being pushed, I've become less of a crazy medical experiment. So I haven't tried it.

Geodon is my favorite. But it doesn't like me. Got me out of some deep dark depression, but it was at the cost of developing tics and having a seizure. If it wasn't for that, I would probably be on it.

I would say NONE unless you are prone to go into manic psychosis. Please try Lithium and Lamicital or anything else (except Abilify) first. Why? They can all give you Tarkive Diskinisa (not spelled right) and askinisia (I don't think that's spelled right either. The first one gives you tics (I move my mouth) and the second you can't sit still. There is no help for TD and I take B-6 for askinisia (I found it on the web). I have to take a lot of it. But it helps. Now I hear all this stuff how the newer anti-psychotics aren't as proned to give you these side effects that may haunt you the rest of your life, but the chance is still there. Seroquel tells you about it may give you TD. I'm on a low dose Cymbalta for depression and it worked wonders. And no mania. I haven't been really manic since 1993. So weigh the risks.

Well he put me on Risperdal. I had a feeling that would be the choice, since money is a huge issue. I think if we get the dose right it might work, we just didn't play with the dose enough before.

I'm actually already on Lithium.....Lithium AND Topamax AND Invega (now Risperdal). Not sure I really need all that, but whatever. I was severely messed up (but never psychotic) in 2008 and that's when they added all this stuff and every time I ask about getting taken off it I get funny responses.

Then again, when I accidentally forgot to put Invega in my Sun-Sat pill container and didn't take it for only 4 days I already noticed a difference in my moods. So.....maybe I need an antipsychotic. I don't know.

I've never been psychotic, ever. I guess I take it to prevent mania. I'm not entirely sure.

Hope it works out.

None at all.

Because Invega and Risperdal are almost similar, if you can cross taper between them, that would be most optimal. I would go with risperdal because of the cheapest cost, plus being closely chemically related to Invega.