Worried about a med swap.

Hi! I've never posted here, but I do have Schizoaffective, so.. I went back to school (college) in January, and the stress caused a psychotic break (I started to hear things again), so I was hospitalized. Whilst inpatient, I was declared treatment resistant (I've been on 10 different antipsychotics) and started on Clozapine. I was discharged a week later, and found out that my outpatient psychiatrist legally isn't allowed to prescribe Clozapine. Neither is my family doctor. You have to be registered with the company that makes it, as you have to have your blood tested weekly and the doctor has to send the results to the drug company for them to review before they'll give you the next week's supply of Clozapine... Neither my family doctor or psychiatrist are registered with the drug company, and therefore cannot prescribe it. So because my psychiatrist couldn't see me that day, and I was going to run out of Clozapine in a day or two, she sent me back to the hospital where I was admitted to the psychiatric ward again. This time I was started on a new antipsychotic, Saphris, which has worked quite well for me for the last few months. I'm able to ignore the voices, which are only there quietly when I am really stressed.

There's only one problem: I've gained at least 10lbs on Saphris. And the last time I gained weight on a med, Seroquel, my psychiatrist took me right off of it, even though it was working. I am afraid she is going to do this again, and really, there aren't a lot of antipsychotic options left for her to go with if she does. I'm afraid she too will agree with the first inpatient doctor and declare me treatment resistant as well, and send me off to a new psychiatrist, as she can't prescribe Clozapine (the last resort med). This makes me nervous, as I hate change, and I've had my psychiatrist since I was 17. I don't want a new one, it will take forever for me to get used to them. They could also disagree about my diagnosis (although I was first diagnosed inpatient when I was 18 by the top doctor at our city's psych hospital, then confirmed by my psychiatrist, who is head of psychiatry for our city, and a psychiatrist who runs the emergency psychiatry services). The other option is for her to just switch me to another antipsychotic that she does have the ability to prescribe, but so many of them haven't worked, I am worried whatever she prescribes next won't either. There's a rare chance that she'll keep me on Saphris, but I doubt it, because I will just continue to gain weight. I can't control my appetite on it. I am screwed no matter what... What should I do?

I've also been on almost all the APs over the years and been considered "resistant." Have you tried Latuda yet? I started it shortly after it came out because i'd been on everything else. Although it took 5 months to get over the initial side effects, I'm now having real good luck with it. No weight gain or brain fog and it does help my psychotic symptoms. I don't think I would want to take clozapine, but that's what I was facing too. I hope you can get something worked out so you don't have to change pdocs.......D.

Hi De. No, I have not tried Latuda. I have been on Risperdal, Abilify, Seroquel, Nozinan, Thorazine, Geodon, Haldol, Loxapine, Clozapine, and Saphris. Saphris works well, but because of the weight gain, I'm not sure my doctor will allow me to stay on it. My doctor doesn't like anything close to Risperdal, because of the possible prolactin issues... I'm not sure if Latuda is close to Risperdal. My last two inpatient doctors had suggested Invega or Trilafon if Clozapine or Saphris didn't work out. Invega because it's specifically for SZA and Trilafon because it's close to Haldol, which worked well for me for a year or so.

I was on Saphris for a while with no weight gain, but everyone's different. It bothered my intestines though. I'm med resistant too and have tried at least 20 different ones. I'm on Latuda now, you have to take it with food,no weight gain and voices and hallucinations at a minimum. Sza also.

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Ah, sounds like Geodon then. I had to take that one with food and there was supposed to be no weight gain. However, my appetite was increased for the week that I took it. I had to go off it because of unbearable migraines. I don't know if Latuda would be the same, then... Those migraines were hell.

I was on geodon for a year and finally had to go off because of an increased amount of hallucinations a blackout and finally a rash all over my torso.

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Rarely does a drug cause weight gain in and of itself. Since you know you have gained weight you may need to keep a food journal and manage your eating habits more closely.

Good wishes on this and in managing your stress better.

That sucks, Worthit. But if it wasn't helping I guess it was for the best.

JD, I haven't been eating all that much more. If anything just an extra snack.

How long did Abilify take to kick in? I'm still hallucinating as of now and it is scary.

What about looking into soe kind of structured weight management program, seeing a dietician, something like that?

You could get somekind of medical professional to look at you diet or suggest some kind of structured weight management if you want to stay with the saphris?

I mean there may be ways to tackle the problem than to just ship you off to another psychiatrist to try yet another med that may or may not work as well

Bita, Abilify never did work for me. I went up to the highest FDA approved dose and I still saw things. I was in the hospital while I was on it, I was changed to Haldol. I hope it works for you.

My psychiatrist took me off the Saphris. She didn't prescribe anything in its place. I started to see human faces and things dancing around my room in circles, and some whispering in my ear. So my grandma took me to the hospital where they prescribed a med I've already been on, Haldol.. My psychiatrist had said that's what she was going to put me back on if I couldn't get by without meds, but my grandma didn't think it was wise to wait the two months it would take to get an appointment with her. I didn't gain any weight on Haldol. It worked for a year, so hopefully the break from it will mean it will work again.

Thanks MinionKitty, I think I want to try Haldol. I cannot deal with my voices. Abilify doesn't work for me at all. The voices keep taunting me and I cannot work or function at all. I'm really sick at the moment. My obsessive compulsive disorder, psychotic symptoms are bothering me. I see people that aren't there physically. I saw a woman and two children in the doctor's room that weren't actually there. A man and his kids as well, and I saw only one kid. The t.v, radio and phone sends me messages. The voices are louder in public places. I hear two evil voices that mocks me. I can't tell what is reality and what is not.

Haldol is a good med. It worked for me really well, no psychosis at all, for about a year. I think if my doctor wasn't so stubborn and raised the dose, it would have worked longer. Just make sure you ask for some Cogentin if you do try Haldol, as Haldol can have some nasty movement side effects. Good luck to you!

I'm on clozapine and haven't noticed any real weight gain its just leveled> the weight is more or less staying put at around 162 pounds and I'm a 6 foot male. Overall I like clozapine and wouldn't mind gaining more weight otherwise am too skinny. Geodon I never liked but I believe it is "weight neutral" lost weight on it. Clozapine is quite alright > it goes straight to the symptoms and takes care of things such as hallucinations. With this you're gonna be drooling big time and also need weekly blood monitoring so can be a hassle to show up every week but even with these drawbacks I like clozapine and fortunately for me I don't work so have plenty of time at my disposal for appointments with the blood nurse.

I've been on Clozapine while inpatient once. I was taken off of it because my psychiatrist is not registered with the company that makes Clozapine, so she could not prescribe it. I did drool big time. Day and night. It was awful. And I hate blood work. I'm only 20 years old, I don't need to be walking around drooling... Lol

I hope your pdoc is fully aware with your issues that you have stated.