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Typical vs A-Typical

Finite

Finite

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I am interested to find out if there are people out there who take a combination of an older Typical Antipsychotic along side a newer A-Typical one?

I used to take the newer med Aripiprazole along with the older med Pipotiazine, which worked pretty well for me, until the latter was discontinued and taken off the market. Since then things haven't been quite as stable.

I don't know if mixing older and newer antipsychotics is common place, but I'm wondering what people's experiences are with taking more than one Antipsychotic, whatever the combination?


💊💊 vs 💊💊
 
NWiddi

NWiddi

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My combination is 10mg of Aripiprazole (atypical) and 4mg of Risperidone (again atypical).

I was just on 30mg of Aripiprazole but I had increased anxiety and restlessness so the plan was to swap for Risperidone, I got up to 4mg of Risperidone but I was still getting unwanted effects from the voice I was hearing so I told my prescribing doctor that I felt better on a combination of each drug so she allowed me to go back on 10mg of Aripiprazole.

Apart from some fatigue I don't get many side effects from this combination in their current dosage, I've been discharged from my mental health team and have no access to my prescribing doctor any more but my GP has me in for a blood test once a year to make sure I'm not doing damage to my organs and my Prolactin levels are ok, she hopefully would have informed me if my last test was a bad result but she does have a tendency to forget about me.

The only other anti-psychotic I was on was Olanzapine (atypical), a terrible drug in my opinion, I put on lots of weight and lost my libido for the duration of being on the drug which was at least a year, I also slept a good 9-10 hours each night.
 
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emmaleemochizuki

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I am on aripiprazole depot and it seems to be working for me. I was apprehensive but I'm better now than I was a month ago.

I have only been on haloperiodol prn but not any other FGAs. only second generation ones. olanzapine, risperidone, and quetiapine all gave me pretty bad weight gain. and quetiapine and olanzapine was really sedating, I was sleeping a hell lot.
 
albagobragh

albagobragh

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My combination is 10mg of Aripiprazole (atypical) and 4mg of Risperidone (again atypical).

I was just on 30mg of Aripiprazole but I had increased anxiety and restlessness so the plan was to swap for Risperidone, I got up to 4mg of Risperidone but I was still getting unwanted effects from the voice I was hearing so I told my prescribing doctor that I felt better on a combination of each drug so she allowed me to go back on 10mg of Aripiprazole.

Apart from some fatigue I don't get many side effects from this combination in their current dosage, I've been discharged from my mental health team and have no access to my prescribing doctor any more but my GP has me in for a blood test once a year to make sure I'm not doing damage to my organs and my Prolactin levels are ok, she hopefully would have informed me if my last test was a bad result but she does have a tendency to forget about me.

The only other anti-psychotic I was on was Olanzapine (atypical), a terrible drug in my opinion, I put on lots of weight and lost my libido for the duration of being on the drug which was at least a year, I also slept a good 9-10 hours each night.
Interesting that you find the combination of Aripiprazole and Risperidone causes some fatigue. When I was on 400mg Aripiprazole depot I said I had some fatigue and was told by a MH professional that it couldn't possibly be down to that as it had the opposite effect.

As for Olanzapine? Agreed, avoid. Caused me to fall asleep at my desk.
 
Finite

Finite

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@NWiddi Thank you for your reply. I'm glad to hear your current combination is working reasonably well for you. I haven't tried double dosing with A-Typical Antipsychotics, as with all of the other's apart from Aripiprazole, the side effects were just too much. Weight gain and fatigue especially. I hope your GP doesn't forget about you!
 
Finite

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@emmaleemochizuki That's good to hear your Aripiprazole depot seems to be working for you. I was on 20mg of Aripiprazole and a Pipotiazine depot. I am now just taking the maximum oral dose of Aripiprazole, which isn't as good. I wonder if you get a higher more concentrated dose on depot? I hear you on the weight gain issues from some of the other FGA's.
 
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emmaleemochizuki

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@emmaleemochizuki That's good to hear your Aripiprazole depot seems to be working for you. I was on 20mg of Aripiprazole and a Pipotiazine depot. I am now just taking the maximum oral dose of Aripiprazole, which isn't as good. I wonder if you get a higher more concentrated dose on depot? I hear you on the weight gain issues from some of the other FGA's.
I think in the uk there's only one dose for aripiprazole depot.
 
Finite

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@albagobragh The time I spent on Olanzapine was awful and like you I'd fall asleep every time I sat down, but the weight gain was the worst for me. Do you know if 400mg is a high dose of Aripiprazole depot?
 
albagobragh

albagobragh

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Hi @Finite,
I gained weight on Olanzapine too.

Aripiprazole 400mg is a high dose and is the standard. Put it this way I went from 400mg depot to 10mg oral and felt a marked difference within a couple of weeks. You can ask your psychiatrist what the equivalent oral dose is. They have the facts and figures.
 
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emmaleemochizuki

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Hi @Finite,
I gained weight on Olanzapine too.

Aripiprazole 400mg is a high dose and is the standard. Put it this way I went from 400mg depot to 10mg oral and felt a marked difference within a couple of weeks. You can ask your psychiatrist what the equivalent oral dose is. They have the facts and figures.
@albagobragh Thank you. I will talk to my psych about the equivalent oral doses :)
I think the equivalent is somewhere around 15mg oral but it is totally dependent on the absorption of the individual person.

I think probably because I am quite a small person compared to average so an average dose for me may not be a working dose for another.
 
Finite

Finite

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I think the equivalent is somewhere around 15mg oral but it is totally dependent on the absorption of the individual person.

I think probably because I am quite a small person compared to average so an average dose for me may not be a working dose for another.
I think that's probably got a lot to do with it. I'm bigger than average and take a fair bit of other medication for comorbid conditions, so I'm sure that plays a part in the way I metabolise meds.
 
Nate

Nate

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I am interested to find out if there are people out there who take a combination of an older Typical Antipsychotic along side a newer A-Typical one?

I used to take the newer med Aripiprazole along with the older med Pipotiazine, which worked pretty well for me, until the latter was discontinued and taken off the market. Since then things haven't been quite as stable.

I don't know if mixing older and newer antipsychotics is common place, but I'm wondering what people's experiences are with taking more than one Antipsychotic, whatever the combination?


💊💊 vs 💊💊
I take paliperidone Wich is a new antipsychotic and I'm also on perphenazine Wich is and oldy. The combination works really well for me, no bad symptoms and hardly any anxiety and depression also my OCD is under control.
 
Finite

Finite

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@Nate Thank you for your reply. I have heard of Paliperidone, which I think is also known as Invega, but I've not come across Perphenazine before. I'm glad the combination is working well for you though and it doesn't leave you with any unwanted side effects.

I think the practice of double dosing must be more widespread than I realised. I'm discussing with my psych about introducing another older antipsychotic to the Aripiprazole and other med mix, but I'm waiting on some bloodwork to come back first.
 
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