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Default Mar 15, 2023 at 03:07 AM
  #1
I am on 30mg Olanzapine, and yet I feel like I have only partially responded. Has anyone else had this problem? If so, what did you do? Would Clozapine be a good alternate option?
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Default Mar 15, 2023 at 10:21 AM
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I am no expert. I thought 20 mg was the highest you could go on Olanzapine. Have you tried Lybalvi? It is Olanzapine and something else. It is supposed to be better metabolically. I tried to take it but it was SO sedating I couldn't handle it. So I went back on Olanzapine. I also take Latuda in conjunction with the Olanzapine because Olanzapine alone wasn't enough. Has your doctor thought of augmenting with something else? I don't know about Clozapine personally because I have never been on it. But I think it is supposed to be really good. So it might be a good option. Do you have a psychiatrist or do you get your meds through your primary care physician? I see a neuro-psychiatrist and he has been really helpful. He doesn't take insurance so he is really expensive but he has probably saved my life. Good luck to you. Let us know how it goes. Hugs if wanted, Kit

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Default Mar 15, 2023 at 07:30 PM
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Thanks, Kit. I have never tried Lybalvi. And you are right that 20mg is the maximum recommended dose for the Olanzapine. I have been on Rexulti as an adjunct to my Olanzapine in the past. And it seemed to be helping a lot. I get my meds through my psychiatrist. He is covered by insurance, but frankly, I don't think he really cares. I have been seeing him for more than a year and all he seems to care about is getting paid. The psychiatrist I was seeing before him was not covered by insurance, but I could tell that he actually cared about my well-being. He was the one that prescribed me Rexulti in addition to my Olanzapine.

My Mother thinks I am on too much medication right now, so I am not really sure if I should inquire about going back on the Rexulti to my current psychiatrist. My guess is that I should just keep my regimen the same for now. I am on Olanzapine 30mg and Escitalopram 30mg.
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Default Mar 16, 2023 at 11:44 AM
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I used to take Rexulti. It helped but it also made me gain a lot of weight. So that was annoying.

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Default Mar 17, 2023 at 02:56 PM
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You could also inquire about aripiprazole. I am on that, and it helps my depression immensely. If that is a concern to you. I am not sure what your main concern is. You said you partially responded to the olanzapine. Does that mean you have psychotic symptoms still? Are you depressed?

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Default Mar 17, 2023 at 10:59 PM
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You could also inquire about aripiprazole. I am on that, and it helps my depression immensely. If that is a concern to you. I am not sure what your main concern is. You said you partially responded to the olanzapine. Does that mean you have psychotic symptoms still? Are you depressed?
I cannot really tell if I am having psychotic symptoms still. I am not sure if I am depressed, either. When I was on Rexulti in addition to what I am on now, there was no question about it. I was definitely sane when I was on Rexulti as an adjunct. And I was definitely not depressed.

But the problem is that I have a lot of side-effects from what I am on right now. And I am not sure if I should add another medication. Thanks for your concern.
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Default Mar 18, 2023 at 02:26 PM
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I cannot really tell if I am having psychotic symptoms still. I am not sure if I am depressed, either. When I was on Rexulti in addition to what I am on now, there was no question about it. I was definitely sane when I was on Rexulti as an adjunct. And I was definitely not depressed.

But the problem is that I have a lot of side-effects from what I am on right now. And I am not sure if I should add another medication. Thanks for your concern.
Ah I understand. Yes, I too was on olanzapine. Obviously I'm not telling you what to do but you could at least inquire about lowering the dose of olanzapine because you're having side effects. And then perhaps inquire about the Rexulti?

And yes, of course. I think if you expressed what you just wrote in that message to your psychiatrist in a kind way, perhaps that psychiatrist would understand.

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Default Mar 19, 2023 at 10:59 PM
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Ah I understand. Yes, I too was on olanzapine. Obviously I'm not telling you what to do but you could at least inquire about lowering the dose of olanzapine because you're having side effects. And then perhaps inquire about the Rexulti?

And yes, of course. I think if you expressed what you just wrote in that message to your psychiatrist in a kind way, perhaps that psychiatrist would understand.
Thanks. My appointment is tomorrow. I plan on telling him that I have been sleeping way too much, and see what he says. And yes, maybe I could express my thoughts about thinking that all he cares about is getting paid; and that he does not care about my well-being.
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Default Apr 07, 2023 at 05:19 AM
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Thanks. My appointment is tomorrow. I plan on telling him that I have been sleeping way too much, and see what he says. And yes, maybe I could express my thoughts about thinking that all he cares about is getting paid; and that he does not care about my well-being.
I'm glad you're speaking up for yourself. My personal (and obviously subjective opinion) is that you maybe shouldn't be quite so harsh about the getting paid thing and that he doesn't care about your well-being, but indeed if that's the right course for you, then by all means go for it.

But definitely, DEFINITELY, always tell your psychiatrist exactly how you're feeling, no matter how hard it is to express or come up with the words, etc.

It will really help you. I saw in your other thread that it seems like you did speak up and I'm hoping that helped you.

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Default Apr 07, 2023 at 05:21 AM
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I'm glad you're speaking up for yourself. My personal (and obviously subjective opinion) is that you maybe shouldn't be quite so harsh about the getting paid thing and that he doesn't care about your well-being, but indeed if that's the right course for you, then by all means go for it.

But definitely, DEFINITELY, always tell your psychiatrist exactly how you're feeling, no matter how hard it is to express or come up with the words, etc.

It will really help you. I saw in your other thread that it seems like you did speak up and I'm hoping that helped you.
Oh and personally, and for whomever this might help, including me, I like writing notes out for my psychiatrist and emailing them or bringing them to the session. It used to feel a little forced for me, since I thought the psychiatrist ought to just "know" how I'm feeling. But as I learn more and more, I feel like it's right to just let them know EXACTLY what's up either beforehand, or during the appointment with these notes, and so then we have an agenda, instead of my psychiatrist basically trying to guess what's going on with me.

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Default May 05, 2023 at 08:42 PM
  #11
I would try Clozapine. I do not think you should be at 50% over the FDA approved max dosage for Zyprexa. And Zyprexa is a strong med: if it does not help you even at this humongous dose, then maybe it is not the right medication for you. Clozapine is a last resort medication and you need to go to the lab regularly to continue taking it, but it helps a lot of people. It is worth asking your psychiatrist to order baseline labs for you and then consider putting you on a trial of Clozapine. I suggest going off Rexulti completely to see what Clozapine alone can do for you.
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Default May 07, 2023 at 09:53 PM
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I would try Clozapine. I do not think you should be at 50% over the FDA approved max dosage for Zyprexa. And Zyprexa is a strong med: if it does not help you even at this humongous dose, then maybe it is not the right medication for you. Clozapine is a last resort medication and you need to go to the lab regularly to continue taking it, but it helps a lot of people. It is worth asking your psychiatrist to order baseline labs for you and then consider putting you on a trial of Clozapine. I suggest going off Rexulti completely to see what Clozapine alone can do for you.
Thanks. I really am considering asking my psych doc about the possibility of trying the Clozapine. He may or may not be receptive to it. But it's worth mentioning. Years ago, I was conversing with someone who went on Clozapine and they said that it was "like a miracle"; they said they got their life back on that medication.
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Default May 10, 2023 at 09:03 PM
  #13
Clozapine saved my life. That's a quote from my therapist. I've been on it 7 years and have had a few moderate depressions and one severe depression. I think I've had 2 brief hypomanias if that.


Some doctors don't prescribe it because they don't want to deal with all the extra paperwork (and I think certification?) and some are afraid of it but in cases where nothing has helped it is great.

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