Looking For Comments On Clozaril

Hi, gang. I actually have bipolar 1, but nowadays, I suffer from a ton of psychotic stuff. Really, I am now closer to a schizoaffective dx than a classic bp 1. But the name doesn't even matter. What matters is I am getting worse.

My doc is talking about Clozaril for me. Wondering if anyone here has any thoughts for me. Thanks in advance--

Here are the downsides...it has the most weight gain of any AP...you need constant bloodwork because it can kill you.....upsides it works almost magically well for people who are deemed treatment resistant. You seem pretty lucid to be considering this imo. Some people here have been on the classic APs with good luck, typically haldol.....you can also mix two APs in some scenarios...the atypicals are drugs that bind to multiple receptors which keeps EPS lower but a classic like haldol will bind the D2 receptor even better than risperdal. So if you mix you can get a strong d2 suppression with something like haldol and reduced eps with something atypical.......however a lot of APs mess with QT...heart stuff, and if they give max doses of both you could have issues. So you want to be at like a half max dose of each ideally. Some pdocs are totally against mixing but a number of people here are functioning on two APs....it’s not always quackery. This is just what I’ve heard over many years...I’m not an md and personally I’m on one AP that works well.....

Thanks a bunch, Sometimes--really appreciate your insights. Yeah, I may sound lucid, but that is only because I have reached some insight over, oh, 15 years of this or so. I am aware that everyone but me strongly believes the CIA is not in a chopper over my building right now ready to rappel into my apt. and kill me. Kind of know that probably, every time I leave my apt., no team of operatives enters somehow and searches. Rearranges furniture to piss me off. No cameras or microphones, most likely. Likely, noone goes through and records all my meds when I am out. So on. Am "aware" that evidently all this auditory stuff I increasingly hear is not actually there, but rather, is my sick brain playing tricks on me yet again. I could go on, but you get the idea.

I guess what I am saying is, after many, many years of this on and off, I have come to a place of a rather sad acceptance about these aspects of my own personal experience and that they are not, in fact, actually occurring. They are just my ill-functioning mind/brain. So, I accept that now. But that doesn't mean I don't live all this.

Anyhoo, I am already on multiple atypicals. Never tried Thorazine. Was briefly on Haldol during one of the 8 zillion hospitalizations, but had to quickly d/c it due to near-catatonia. So, now, in part due to increasing psychotic symptoms as well as more SI stuff, my very bright pdoc is talking maybe trying a lowish dose of Clozaril. So, that is where this is all coming from. As you may know, probably do, Clozaril is one of only 3 really meds that can significantly impact suicidal ideation. I am already on the most well-known of those--lithium, but I am still struggling.

Anyway, thanks very much for taking the time to respond so thoughtfully. Much appreciated!!

Ok....I totally understand not wanting the psychosis even if you have insight.....it has to be tiring at best. I know there’s one guy here on cloazaril....but he’s not on here often....hopefully he responds to this post.

Have you tried a non-PRN dosage of Zyprexa? Like a consistent dose of Zyprexa? IMO Clozaril is a big deal to jump to if you haven't tried Zyprexa full-time. Or have you tried Risperdal? The thing is, I take Abilify and Zyprexa. The Abilify helps with my severe depression, while the Zyprexa helps with my psychotic thoughts. It might give you some hope to know that two atypicals can work in conjunction with one another.

But, that said, Clozaril is a good drug, I have heard, though it does have many possible side effects. It's also a pain in the butt because you have to get bloodwork so often to make sure your white blood cell count doesn't drop to a dangerous level.

I tried Clozaril for a time but the side effects were too many for me. It messed with my heart (QT interval prolongation). I'm not trying to scare you, just trying to make sure you're educated about it.

That said, I'd probably opt for an atypical like Zyprexa or Risperdal before I'd go to Clozaril.

Have to agree with this...zyprexa was originally designed to be a non lethal version of clozaril.....

I've been on Zyprexa now for about six months and it's helped enormously with my psychosis but I've gained a lot of weight from it which is common for this drug. So I may have to try something else.

I really appreciate this thread because I've been having to accept that I've been psychotic, off and on, for over ten years.

Weight neutral meds include geodon and latuda and for some people abilify.....if you’re looking for an atypical. I personally have gained on abilify but zyprexa is one of the worst for weight gain. According to my pdoc they all have some gain.

I was on Clozaril for about a year. It was extremely effective when nothing else would touch my mania or psychosis. I found it more weight friendly than Zyprexa, but still gained a lot on it. It also had me sleeping about 12 hours a day. Now I'm on Risperdal Consta shots which doesn't work as well but it's weight friendly for me and I only sleep about 8 hours a night (and I don't have to worry about missing doses/it's easier to stay "compliant").

Hey, thanks a bunch for responding, Asparagus--really appreciate it. Yeah, I have been on Zyprexa full-time in the past. It brought me out of a badass mania, but I had no psychosis back then. Was on Risperdal for two years. It helped, but I did have some breakthrough psychotic symptoms on it, despite a highish dose. Am currently on Abilify at 30, sort of the max. Obviously, not working fully for me. I will see my doc again Monday and will discuss scheduling another AP along with the Abilify, as you suggest. But I have to admit, at this point, after everything I've tried and been through and how long it has been, I am skeptical.

Will keep you posted as this thing moves forward. It is possible he may admit me on Monday. He was quite worried about my safety on Friday. But I won't SH--it's firm commitment.

Thank you so much for sharing. I will eat the universe and everything in it on a scheduled dose of Zyprexa--but I am willing to accept that if it helps me with this misery and risk of S. Fortunately, it sounds like you have some other med options available to you. I really hope you can find one that suits you soon.

Oh--that is good to hear that it helped you. Thanks for responding!!