Family and Caregiver Schizophrenia Discussion Forum

Clozapine vs Invega?

My son is doing ok on Invega (second full shot 117 yesterday). Except he seems pretty sedated. Does Clozapine have the same sedated affect? I imagine it’s different per individual… OR should I ask the doctor about reducing the mg? We have an appt. next week.

I think 117 mg is pretty low, especially after how far into his illness your son went before he started the medication. In my opinion, it hasn’t been very long, so I’d stay on course for another month, to see if his body adjusts.

How sedated is he? Is he complaining? Even if he is complaining, that’s not necessarily a reason to act.

Hopefully others will chime in.

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My son is on clozapine, a high dose, 600mg all taken before bed in one dose. He sleeps hard, but doesn’t seem sedated while awake. He was on the Invega shot (the high dose) but only for a couple of months so I can’t really speak to that one. Hope that helps.

DianeR, sorry for not mentioning this in my previous post…

Now that I think about it, I do remember my son needing time to adjust to the Invega Sustenna, especially for the first few days after the injection. He did complain about being tired and that made me scared he’d start to refuse the next injections. I just acknowledged his complaints by saying “If your tired, take a nap. I’d rather be tired than really scared.” He kept going with the med and he doesn’t complain about it anymore. I do think his body adjusted.

My son goes in and out of phases of particularly low energy, but I’m pretty sure that’s the illness cycling.

@Leiann and @Day-by-Day Thank you for your responses. I guess I will need to continue to monitor since this is just the beginning. On another note - last night my son went to work! So he must feel ok. It was an 8 hour shift. We’ll have to see how this plays out.


Wow amazing. What kind of job?

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@Day-by-Day Right? He’s a night stocker at a grocery store. Did a full shift and going back tonight. He actually looks pretty good. I’m in shock. But I’ll take it!


In my experience whether it is Invega or Clozapine, the extreme drowsiness will eventually level out or at least it did for my son. He was always a long sleeper 11-12 hours since birth. When he started Invega and then later when he switched to clozapine he slept sometimes up to 18-20 hours and it worried me but the doctor said just give it some time, I don’t recall how long it was but it was at least a couple of months or more before he went back to his 11-12 hours which was his norm. So very true how different everyone is and yet in some ways similar.


Im thinking about changing my son’s meds from clozapine to Invega, which is a form of Respirdol right?
The Clozapine really has him out of it where he does not function even a little, he is very forgetful, and does not know one day to the next, any suggestions on this?

My 59 year old Sz younger brother has been on Invega Sustenna successfully for over a year and a half. He was started with a few high doses which were lowered to a maintenance level month by month. The first few days after the shot, he was sluggish. and his low, slurred voice reflected this. As the month progressed, he improved. This effect occurred for months, slowly diminishing over the first year.
He is far more stable on Sustena as compared to the Risperidol Consta which seemed to wear off and lead to relapses in the days just before the bi-monthly shot. Two things that were helpful were weekly visits by a social worker who worked closely with the psychiatrist. As his guardian, I was able to keep in contact with all his medical care providers.
After six months on Sustenna, he had blood work and a Primary Care visit. His cholesterol levels and weight were up dramatically. For some, this is a side effect with the Risperidone family. My brother likes to exercise compulsively and he complained often that it was hard to do so. The PC discussed this with the Psychiatrist and he was prescribed both Vitamin B and D. His recent checkup showed great improvement in weight loss and cholesterol. With some help, he is living peacefully and independently and is in excellent health. It is possible that he will continue to improve, but if this proves to be as good as it gets, its been a miracle.,

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This is all very helpful. We are going to first psych doc appointment today. Thank you!

@siskavich Clozapine is an antipsychotic medication that is used to treat severe schizophrenia symptoms in people who have not responded to other medications. It is also used to help reduce the risk of suicidal behavior in people with schizophrenia or similar disorders. Do you know why your son is on Clozapine? Invega is paliperidone. There is lots of basic medical information about all the different antipsychotics on the internet. Are you able to talk to his doctor? If the doctor won’t share information with you, you could reach out to the doctor and just tell him your observations about your son’s level of functioning.

@siskavich and @hope4us They gave my son Respirdol in the hospital and said that was ok to give him the Invega shot because he didn’t have bad side effects from the respirdol.

I just read that it’s ok to mix sarcosine with Invega but NOT clozapine. Does anyone have experience with combining sarcosine with these meds?

I found this previously posted in the Forum…Using sarcosine

Its not that sarcosine causes any problems with people taking clozapine - its just that two studies show no added benefit from taking the sarcosine. You can read up on people’s experiences on the “diagnosed” forum - lots of people have tried it and talked about it:

@hope4us and @SzAdmin Thank you for the info! The Doctor said fine to take as well.

My grandson is on 450mg clozapine, he sleeps hard but is able to function normally during the day. He had gained 100 pounds but has since taken off 75. He does have the excessive drooling at night. It’s been a miracle drug for him

I read that your son switched from invega sustenna to clozapine. My son has been taking invega shots and before that he was taking consta shots and none have these have failed to show any significant benefit for him. This has been going for 4 years now. Instead of changing his invega doctors have continued to add layers of other antipsychotics to these like haldol, zyprexa and depakote. Now I have talked to the doctor and she is open to discontinuing the invega with the option of starting him on haldol lai long acting injection. And after that she is also open to starting clozapine. Can you please share how your doctor swiched your son from invega to clozapine and also is he on additional antipsychotics as well in addition to clozapine. Thanks. Pally

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My son started of on Geodon, then Risperidol, then Invega (oral), then Abilify, then finally Clozapine, this whole thing took about 3 years of changes before we settled on the clozapine. He admitted him to the hospital for a week to titrate him up to the correct dosage. About 4 years into the clozapine treatment my son developed an atypical seizure disorder which no one knew conclusively what caused it. So now he takes Depakote for that and the clozapine and benztropine which helps with night time drooling (a minor side effect of the clozapine). That’s all he takes currently. My son never took Haldol,

I think you have to be very forceful sometimes in advocating for your son, at least I did. Some doctors drag their feet on making changes in a reasonably timely manner. Years with little to no changes or improvements is way too long, a few months is sufficient. With clozapine the results occur at a very slow steady rate but they do occur…and without clozapine my son wouldn’t be as well as he is today. Everyone is different though. I would advise to do as much reading and research on the medications your son’s doctor recommends so you can have the right questions to ask when you talk to her. Best wishes.