Clozapine plus what?

Hi
My son has been on Clozapine since November. He is also on a low dose of Zyprexa plus a bunch of other things. I am wondering what antipsychotics work well with Clozapine as it doesn’t appear he will ever be able to be on Cloz alone and I know that Zyprexa isn’t ideal with Cloz. Not looking for medical advice, just anecdotal experience.Thank you!

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My son’s pdoc is definitely a single AP prescriber. My son has been on clozapine since January. He still has delusions, but is much improved. Why are you looking for another AP?

He is very ill and has never been on only one AP. I know that Zyprexa isn’t great with clozapine and I know that many/most people with severe SZ who use cloz are not only on clozapine.

Unfortunately, from what I have read, study results are inconclusive whether adding another AP is of significant benefit. But it could still help your son.

Well without both he’d be in the hospital, so not being on two isn’t an option unfortunately.

Yes - generally this approach - which is called “Polypharmacy” (i.e. multiple antipsychotic pharmaceuticals at the same time) is not well supported by the evidence.

You can search on “polypharmacy schizophrenia” on pubmed.org
polypharmacy schizophrenia - Search Results - PubMed

and here are some samples below of the research:

and

and

I wish one drug worked! Thanks everyone. I’m all set now! :slight_smile:

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I will add that even tho my son’s pdoc prefers to prescribe only 1 AP, he has been good with 1) doing multiple trials if something isn’t working, and 2) adding in other meds, such as mood stablilizers, anti-anxiety meds, depression meds, and sleep aides.

Have you tried the supplements like NAC, B complex and sarcosine? If you do a search on the Diagnosed board, you can see that they get great write-ups from a lot of people with sz.

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Husband has been on 250-300mg of clozapine and clonazepam 0.5mg for anxiety. He wants to try and include sarcosine to hrlp with negativecaffects of clozapine.

Sarcosine is not actually a remedy for side effects of anti-psychotics. It is supposed to be used alongside antipsychotics to counteract the negative symptoms of schizophrenia. Your partner may feel that the negative symptoms are side effects of APs, but it’s not actually the case. It may just be that s/he only notices them when s/he is on APs and the positive symptoms become less overwhelming so the negative symptoms can be perceived.

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Hi. My daughter is on Clozapine for auditory hallucinations, as well as Lamictal and Clonidine. This past fall we added Latuda, as she was becoming more agitated. In the years since adding the Clozapine my daughter went from in patient to day treatment, to eventually being able to function in her home high school, in a specialized program. Unfortunately, it’s incredibly difficult to find a competent child psychiatrist, and the meds can feel like a game of chance to find what works. Good luck to you.